HomeMy WebLinkAbout218 22ND ST - Building Permits I
MF CITY OF COSTA MESA •
9 BUILDING DIVISION
e r��..k DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
4,r. B03-00868
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 218 22ND ST Status: ISSUED
Suite: Applied: 05/27/2003
Vicinity: ROOF Issued: 05/27/2003
Parcel Number: 42607123 Zoning:
Applicant: WILBER, SHARON ISSUED BY: C
Address: 10501 CLAUDIA CIR
Phone: (714)827-0861
CYPRESS.CA Zip: 90630
Owner DURNALL, DOUGLAS A
Address % 218 E 22ND ST
Phone:
COSTA MESA,CA Zip: 92627-1812
Contractor: WILBER ROOFING INC
Address: 10501 CLAUDIA CIR
Phone: (714)827-0861
CYPRESS,CA
Zip: 90630 License: 322179
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING. INSTALL CLASS A FIBERGLASS SHINGLES, 15#FELT.AND REPLACE SHEATHING AS NEEDED. 14 SQUARES.
FEE SUMMARY /
Plan Check: $0.00 Calc Valuation: $2,790.00
Permit: $83.25 -Claim Valuation: $2,790.00
SMIP Res: $0.50
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
PLANNING&ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I have and wilt 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.
-Z,'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: STA 1' Jr-N ND Policy Number: al F. S /
(This section need not be completed if the permit is valued et one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for which this p reit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Californl and agree that If I sho I ecome subject to the workers'compensation provisions of Section 3700 of he Labor Code,I shall forthwith
comply with these pros _ q
Applicant Signature //1/ Date: • -C/� o7 3
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIE AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE(5100,00),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 provl Ions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full
force and effect.Llc.k 32.z#,./-2A., Class ft C-3 9
Contractor's Signature: ,/Lr- Date: S/Z7�G 3
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 for a permit
subjects the applicant to a civil penalty of not more than 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 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 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. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,I.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,Califomia 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 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 ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? PI Yes LJ 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? ❑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.
ignaturera ner(s) Date
And/Or Authorized Applicant Date
CODE x INSPECTION TYPE PAIS 1NTRIAL$ CODEC INSPECTION TYPE RATE RIIIDELS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 0-03 210 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
A��RESAOF BUILDING: 218 22ND St UMT: CITY OF COSTA MESA — BUILDING PERMIT
c;:elRSRaMEIFt0aiN: NEALON, LUCILLE PERM NO: B 074804
ADDRESS: 218 22ND ST
COSTA MESA,CA 92627 PERMIT NO: B 074804 PLAN CHECK NO: 04058-95 A GOVT: N SUPP : N
APPL.MAKING ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STIR PURPOSE: ADD
• MI'ck a ' ' e, 0 S tR3°�
ARCHITECTO -- 7-- —__:- -(• �/� - ,Q T�UC. 76: JOB DESCRIPTION : NEW GARAGE AND WORKSHOP 1010 SQ FT SQ FT: 1 , 010
ARCH.on ENG.'S Sr.' ,: yr+a W-02D t I 5 urn -4=1:0
NEWPORT BEACH CA 92660 a5b CLAIM VALUE: 10, 000 .00 CALC—VALUE: 20, 806 . 00 GROUP OCC: M-1 /
CONTRACTORS NAME:
CaIWACTORSMMIN+D COMMENTS : NEW GARAGE 700 SQ FT/ NEW WORKSHOP 310 SQ FT
ADDRESS) LW.NO.: BE1EBEiE1EiEdEiEfElEiEiEiEfEikiElEREfEiEiEBk***BEak***If1FlF1E#ifif-1F1E1EiE1ElElEifiElE*** fE1EiE1EiE1E#1(•1F1P1E#�EfEiE1EfE1E1ElE1EiEifiE1E***
UMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I em licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force and effect.
CITY LIC.NO.: UC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: 68 FT IN REAR: 62 FT IN
Date: Contractor: LEFT: FT IN RGHT: FT IN LEFT: 5 FT IN RGHT: 45 FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty d perjury that I ern exempt from the Contractors License Law for the
following reason(Section 7031.5 Business and Professions Code:Any city or county whim requires a permit to=weird,ane'improve, PARKING REQ: P RO V: PARCEL. 42607123 Z N E: R1 REF NO:
( moensedpurssuuanttotheprovisionsoftheContractoor to its issuance,rsLiicenseLawuires the�Chaptertfor such 9(commencingrmit lo file a withSeciione7statement 000)ofDiieion3oftha PLANNING NOTES> ADD- '700 SQ FT. GARAGE AND 310 SQ. FT. WORKSHOP TO LEFT SIDE
' Anus and Professbns Ccdat or that he oi she is exempt therefrom and the basis for the alleged exemption.Any vbletbn of Section ,> .OF EXISTING SINGLE FAMILY RESIDENCE.
'031.5 by any applicant for a permit subpar the applicant to a civil penalty d net more fee hundred dollen Rkdkgk*1E1ERkikiE*4RE1Edkd6gE1E7klE*kIE44k1kakaElElEak4akakakak*1E♦E*1EIE♦Ea6RkikikiE*iEiEIEiEiEiEiE*?rt*iE*k*#Hk***1E1EiEi(-iaiEaEiElfiE161E
❑ I.as owner of the property or my employees with wages as their sole compensation,will do the work,and the structure is nol intended DEVELOPMENT SERVICES R E Q U I R E M E N T S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an ownerd property
who bolds or improves thereon.end who does such work himself or herself or through his or her own employees.provided that such / )GL/�
improvements are not intended a offered for-sale.N;however,the building a' - ant is••within one year of completion,the ZONING APPROVED BY i E .t��DK. DATE: ID—25--95—
LpJ,
s, wt W
ownerbuilder will have the burden of arming he or she did cwt or int• or the pu• d sale).L as owner of propend.em exdusive contracting with licensed.• t. construct e project(Section 7044,Business end BUILDING APPROVED BY 1/6A DATE: 10-05'95-
Professions Code:The Contractors License Law does not apply to property v o builds or improves thereon end who
contracts for such projects with a contrail s)licensed pursuant '• e• as LiceLaw). i
❑ Iamexempt under se ion. ('] •,:B.aP.c..fO h p ,, /2' / APPLICATION ISSUED BY: - DATE: rO-Z.595—
Date: \r'-l4\ Owner:-. rl1�Af// qt#iE1Ei('iEitiflEiE#1titlEfEltititiFdEfE#1EaE1E1EiE1E1E#HtfFltititltit** iE3E##iFifit iE iE iF tE iF iE it 1E 1f 1E 1E 1t iE iE iE it it i(-3E iF It iE lE it iE It lE
��� LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware of and understand the requirements of Calif• Safety Code Sections 25505,244s3,end
25534,and that I or any tenure building occupant will Iw41 rot(drab one)need to rte said roma codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
apennh for constructimor modification from thea uua ananagement District Res'. constwdion applcationsare exempt from these PERMIT 216 .00 2 . 08
provisions.
Date: Applicant:_-_ PLAN 35 . 10 SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following decimation: ISSUE FEE
❑ Ihave and wilmaintain acenitcmedoonsenitoself-insure for workers'compensatio ,mprov
nidedlogSection BUILDING—DIV—> PERMIT ISSUE PLANCHECK TOTAL PAID DUE
Code.for the performance
dlhe wakf«winch issued.
proms i.ieae. TOTALS----> 218 .08 0 . 00 35. 10 253 . 18 253:: 18 . 00
❑ I have end will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the
work for which this penin is issued.My workers'compensation insurance comer and policy number are:
Caner: REVENUE DIVISION TOTALS--> COLLECTED: 218 .08 OVER/SHORT: . 00
Policy Number: S BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
,semen need not be completed a the penmit is for one hundred dollre( lees.) / 216 .00 2 . 08
N I cert that in theperformance of the work ler which this - ias Ina em•• an in an manner so as to
certify pe Y penin Y
become subject to the worker'compensation Laws a Cd'.E - ..ren that H '. id become wbl.• to the workers' 1ElE#1E1EIEfE1f1E1ElEiEfE1E1E1E1E1EiE1E1E1E1ElE1E1EiF1E#1E1E1EiE1EiEiElflki4#fElEIEIEIE1FiE1kiElElEiEiElE1E1f1EfE1E****1EiElEiflElElElEjE1E#1EIE***
C� compensation prov/is�ionss ol. ion of the Labor Cade,I Y/tri y, pat le— • • �-_ INDIVIDUAL .F E E B R E A K D O W N '•
Y Date: t A) ` ✓? 1N. Applicant: WAY _ /
(�• Warning:Failure to secure workers'compsnsadon coverage la unlawful,and )Sub an employer to criminal penalties sod TYPE QTY D E $ C R I P T I O N UNIT COST TOTAL COST
civil linos up to one hundred thousand dollars(slog OOOA in addition to the of••mpensatlon•damages a provided ler In
section aloe of the Labor Coen,Interest,and adomsyifeat SFR 1010 RES—GARAGES TYPE V ' 20 .60 f• 20, 806 .00
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of per try that there Is a construction lending agency for the END 'OF FEES v- '
performance of the work for whim this permit is issued(Section 3097,Civ.C), .
LENDER'S NAME: 7
.,r. r
LENDER'S ADDRESS: ii ty,
I cents that) this application and'ate that the above information is correil.I agreetocompy with all city and county ordinances ,,
and state laws •to Wilding.v .. m
• and hereby authorize representatives a this city to enter upon the above-mentioned proper 'ope .
mr the on• :•. s. VAHA' SIMIDIAN � •
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ery-ADPltcont;Fink-Revanw;Goldenrod-Assessor •
IO CONSTRUCTION AND PLANNING 1 P001 'RA
,. APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
ri 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . r•
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
tr-3:ElectricaiC•oriduit Utility-Undrgrnd. 54. Forms
......-,. 1. ._ ,
-'2,4. pectrica)A 'r uit-Undrgrnd. 55. Electrical Bonding
• :-.--5--. Steel RaijIfgi"cement ` ( -"g Cad • 56. Rough Plumbing& Pressure Test ,!
'76. Electrical_ ,gR Grnd. ttho gips.( 57. APPROVAL TO COVER-GUNITE
,L�7. Footings, r; L G WGT 58. Electrical Conduit-Undrgrnd. -
`8. Foundatipn'� �•77 +.I
( r�6"G✓< 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pi'd-Undrgrnd. - 60. Backwash Lines, P-Trap, DIllndrgrnd. .
10. Structural Floor System : 61. APPROVAL TO DECK
11. Property.Sewer Line & House Connection 62. Backwash & Recaptor-Fina(
a'
12. sewer Cap 63. Heater & Vent-Final -_ 7, _
13. Roof Drains ;,.' 64. Plumbing System - Final
14. Rough Plumbing8 . : 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final •
h Electric Wiringr
16. Rough I 67. Fencing & Access Approval '.
17. Rough WirinigSign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air ConditioningV F1RD ,P
E, TrREDUIIEMENrT cc
20. .,:Rougn F§htor Fke4lace y' c,, , T J T i, r APPI OVA, = Pe mit # lin'
21. iDucts, inStructure-k • -• i--,s t' S C' r+:r 70. Jndetg'"ta rid .. •dro xs.
r n ,-I n : ts
22. Ducts, VentilSting., - _� - _ 14. - i72-*t• 71. Produettiping°DGas 0 Oil
23. las Pipe-Rough & Test -,„ i.- r'l m t1; P.r. ,}' 72. Underground ETttsh`: , -
24. rRooYFraming" r--;' - , rr _,* 7T Undergrnd.Stoi g�;Tank 0 Gas 0 Oil
25. RoofSheathing ; . _ t..-1,...y:.44; /( 4. 7-Qvdrrhead Hydr9.`
26. T-Ba:.Ceiling (Str`cfural) & Moat C;=, '- -a 7 jcDry.-Chetntgal �6
27. FrarDeart� Flashigrgx u�fs,. -Z,R7-16 /(,rye 76. DryStar�"7pipe'TQ' ,7 CO
- 28. Lathing Er"SiiiIng�±,. � -3w v 1;: ` •-I ..l •
.. 777 FIXED ,' STES/T',FINA1,-+ r a:
29. Insulation: • Ji' ••Z t 4ti;;_ 7k FIRE PREV. F.,1 ,L .4.,. .--- R
30. Drywall gallingcr* ,1 _ �f .ALT, I DEP*frREOUIRbMENT
g ;
31. Plaster Brown-Coati* > • n : f-rt--r r . 4 * ? 79. FINAL INSPECTION 7
32. _glectricaf_Power Metter-F,Unal ; r, ;. '• _�,I Gx -1: 8(11, FOOD CERTI FLCATE ISS.I;IED, rt'
- 33. finkiiEleytric- 3 r sn i •yr 1 M
* ' ', etes: -27-; :4' _ G, '-
• 34. -Finar-Heating_& Ag Conditionid'g-` C-""'" spy` /z 9//.�(--t,,....""7.2 G.�//j c '
35. f,inai GajPipe:Te;tjg r••y .'-ym ,-, I , f _ ..,:., Cr-s x
•
= 36. -Hood-or'Canopy =:. - i 1" , ci ' C, i ht, T - _ r='
4y - C. � a'rr x I 1 4er _ _ m
37. `FJnal.Faetory Fireplace ;• i,i-. O'-ma :v
ni lc
38. 'Final Pl�bing '-'E rt; n* `x S t n
. . _ ..t r- I cn CO *. � i r• r H _ t'
39. Watei Service_Final , .s- t I -,- r *-'3;
- 40. Gas ServfCe-Final - m, ia •r c'T t 'x C.•- c 1
_
41. %olar Domestis•F al ' j....-;j -- n`-' i 7a, *
w : r.
42. Backflow Preventeri CO 7', '-G * F{ *- �r'^ ' } J
'r: s *
43. Backflow Irrigation; ,,, * C: * •
x 1 r 'o
•44. Landscape Irrigation'System ttl"f rcc y m iii- C L^ t ex. 7:i N :.i t? -
c'.- 'T1 C- r < <4 44 .-
5. Sound A(ten,iation.. # 1 t F• -C�� m 1."e
46. Handicap•Regulations +_ c. 4. rr - '-5 '-D='' z 16. _y}7c6s^/-5, _L
47. FINAL STRUCTURE & BUILD"ING "
48. EINA.LPLANNING I r-•`, '' n1 '1 ti: *
c
49. Electric Release to Odison = -, ; t r x _
50. Gas Release to Southern California-Gas Go : F C • ii-..- -
51. CERTIFICATE OF OCCUPANCY` t. * tv
No Date
ADDRES.'.OF BUILDING: 218 22ND ST • UM!: CITY OF COSTA MESA — BUILDING PERMIT
rGVNERSNAMEIF MSOMN: NEALON, LUCILLE "PERM NO: E 076282
ADDRESS: 218 22ND ST
1 COSTA MESA,CA 92627 PERMIT NO: E 076282 PLAN CHECK NO: N GOVT: N SUPP : N
7 APm.m. NGESS: le. S� • A CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ADD
62939
41 ARCNRECT0 ENN GINNEER: _ , 7.�Fi¢ohU X oZ JOB DESCRIPTION : NEW GARAGE AND WORKSHOP 1010 SQ FT SQ FT:
rr
ARCM OR ENG.'S SS: r '" __ ' .: uMT:
trTtY BEACH . Pa CA 92660 CLAIM VALUE: CALC—VALUE: GROUP OCC: M /
CONTRACTOR'S NAME:
CONTRACTORS MAUNG COMMENTS : REF: B-74804
ADDRESS: UC.NO.: *******************************************************************************
UNT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.
CITY LIC.NO.: UC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING
Dae: Contractor: LEFT:
FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury Mal I em exempt from the Contractors License Law for the
tollowng reason(Section 7031.5 Business and Professions Code:Any city o county which requires a penult to construct alta,improve. PARKING REQ: P RO V: PARCEL : 42607123 Z N E : REF NO:
semolish,or repair any structure,prior to nsuch s issuance,also requires the applicant for ah permit to file a signed statement that he or she
licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 of the PLANNING NOTES>
sine's and Professions Code(or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section >
'031.5 by any applicant for a permit subjects the applicant toe civil penalty of not more than five hundred dollars(550DD. *******************************************************************************
0 I.as owner of the properly or my employees with wages as thee sole compensation,will do the work.and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS
or offered for sale(Section 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 herseff or thr.,.h his o,her own employees,provided that such • v
improvements are not intended o offered for sale.5,however,the building oand
r.•�'• enl is sold within one year d completion,the
} oner-wilder will have the burden oproving heoshe did norwildorimp. the purpose•),,,.), ZONING APPROVED BY ; DATE:
C7
I,esowner ol the:T properly.am cors icontracting with lop. to.• troch - malrua the:eject(Section 7064,eon en who BUILDING APPROVED BY DATE:
Professions Code:The Contractors License Law does not ap• : 0 . • ..:rty who wilds or improves thereon and who
contracts for such prgects with a Contrector(s)licensed pus : 1 t•the . as Linen ). •. rr
exempt under Section: B.a P.C..for / It �` APPLICATION ISSUED BY: •n DATE: Z 1111 b
a/t-4�� owner: ,, , �- **************************************Sl�E3E 3t3�32**********************• •f 3FiF**
Date �J LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N
hereby certify that e of and understand the recur ents of California defy Code Sections 25505,puna,and
25534,and that I a any future building occupant will/will not .rob ow)need to com stale codes end the requirements ler
a permit for construction or modification from the Air Quality Management District.Resid• f .. ruction appksationsare exempt from these PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. 9 75
Date: Applicant: 50%
SMIP/;ON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN
ElIhave and wilmaintanacodifameof consent losef3nsure for workes•compensation.es provided for bySection 3700ofthe Labor ISSUE FEE 15 . 00
Code,fotheperamanceothe work for which this permit ialsaued. BUILDING DIV > PERMIT ISSUE PLAN CHECK TOTAL PAIDUE
El I have end oil maintain workers'compensation insurance,as required by Section 3700 of the Labor Code.ler the performance of the
TOTALS————> 9 . 75
15 . 0 0 0 . 0 0
24 . 75
2 4 . 7 0 0
work for which this permit is issued.My workers'compensation insurance carrier and policy number are:
Carrier: At
REVENUE DIVISION TOTALS > COLLECTED : 24 . 75 OVER/SHORT: 00
Policy Number: �� BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
.a section need not be completed I the permit is For one hundred doll.- 100 .) 24 . 75
® 1 certiy That in the performance of the work for which this permit':i- -I not - ploy any person in any manner so as to
become subject to the workers compensation laws o Calif. b, and rl .' . M become subject to the workers' *******************************************************************************
nulbn aloes d Section 3700 of the labor Code, olh Mose
¢/a°: ..c—/4 Applicant:' /r�i�• — INDIVIDUAL F E E BREAKDOWN
We g:Fellun s°cuh work.,.roim:0=on coverage l nle y,an snarl ;loser an ampyoyer to cdnine!penaroas and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Bros tc ro ave Labord ed rhpuures ddbra(tr W,000A In eddlUon ro M rosf i conpenserbn,0emeps ss prpvlded ler In
Section 3706 of the Code,Interest,and attorneys teat ELE 6 FIXTURES LIGHTING 1 ST 20 EA. . 75 4 . 50
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a canamction lending agency for the ELE 4 RECEPT/OOTL ET 11 ST 20 EA. . 75 3 . 00
padormarwed me work f«sun«n this perm)is ensued(Section a097,Ch.G). ELE 3 RECEPT/SWITCH 1 ST 20 EA. . 75 2 . 25
LENDER'S NAME: END OF FEES
LENDER'S ADDRESS:
I certify that I have read this application and slate that the above information is cones.I agree to comply with all ply and county ordinances
and stale laws :.r.to building.. „ and hereby aknhorae representatives of this ply to enter upon the abovre 'mentkcsd property
loins bnpu•• -
VAHA /SJIMIDIAN v
yr/4 i //'A // Dale: 11� -
'
gn,.re•fa •db•entrApplicanVComraaa VVV ir' V•
(515146 W P) •hi. :uirdng 8 Safety:Green-Ale;Canary-App4cent;Pink-Revenue;Goldenrod-Assessor
• CONSTRUCTION AND PLANNING - POOt PA •
APPROVALS Permit# Date Inspector APPROVALS Permit# Date .Inspector
1, Temporary,'Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement i"
3. Electrical:Conduit Utility-Undrgrnd. • 54. Forms -
- 4. £Iectridal'Conduit-Undrgrnd. '' 55. Electrical Bonding
•. I
5, Steel ReirLfb'rcement 56. Rough Plumbing & Pressure Test -
6. Electrical t:FER Grnd. 57. APPROVAL TO COVER-GUNITE `
h r -
..7. Footings t '. 58. Electrical Conduit-Undrgrnd.
t_
8. Foundbti9n 59. Gas Pipe, 0 Undrgrnd.,Test
r
9. Water PiPi,Undrgrnd. -. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System - - 1 61. APPROVAL TO DECK _•�.
11. Property Seaver Line & House Connection - - 62. Backwash & Receptor-Final,
.
12. Sewef'Cap 63. Heater & Vent-Final
13. Roof Drains- - - 64. Plumbing System -Final
14. Rough Plumbing • 65. Electrical-Final t'
15. Rough Electrical-Conduit 66. Solar System-Final • rl , '(
I
16. Rough Electric Wiring •-1 67. Fencing & Access Approval
17. Rough Wiring Sign 66. APPROVED FOR PLASTERING
r . _
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning _ FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace - - - APPROV.ALS.. 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 0 Oil
25. Roof Sheathing - - _.
74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monbcoat 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 - '9, 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 . , • _MEM 7. y
37, Final Factory Fireplace ,
- 38. Final Plumbing -
39. Water Service-Final
40. Gas Service-Final . •
41. Solar Domestic-Final .
42. Backflow Preventer " " ,
43. Backf low Irrigation - -
44. Landscape Irrigation System •- ' - _
45. Sound Attenuation -
46. Handicap Regulations
'
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING - •-�
49. Electric Release to Edison _ • •
50. Gas Release to Southern California Gas Co - 1
51. CERTIFICATE OF OCCUPANCY •
No. Date
- ADDRESS OF'GLGNO: 218 22ND ST WIT: CITY OF COSTA MESA - BUILDING PERMIT
a•NERs rAME IF MOWN: NEALON, LUCILLE ,/PERM NO: P 074891
ADDRESS: 218 22ND ST
COSTA MESA, CA 92627 PERMIT NO: P 074891 PLAN CHECK NO: N GOVT: N SUPP : N
ADPL.WIWq ADDRESS: Me 001 ate le Ga p QI CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH
ARCHITECT OR EMBERUG: : * 5443 / JOB DESCRIPTION : NEW GARAGE AND WORKSHOP 1010 SQ FT SQ FT:
ARCH.OR ENG"ADDRESS: �ZO I&C.h S T. INT: (
NEWPORT BEACH CA 92660 AS> CLAIM VALUE: CALC-VALUE: GROUP OCC: M-1 /
CONTRACTORS NAME:
CONTRACTORSMARIIA COMMENTS : NEW GARAGE 700 SQ FT/ NEW WORKSHOP 310 SQ FT / REF B-74804
ADDRESS: UC.NO: *#1E1E****iECN1E1E1N1E1E#1E1k1NdN1E1N**** 1N1N****1N1N1N1N1bc1E1N1EiE#iE1EiEcf9E1E1E fE1E1E1f1E1E1E�E1ElE1E1EiE�F1E1E1E1E1E#lElE9E1F1E***
WET: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby elfin under penaly of perjury that Ian licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)d DNeon O d the Business and Professions Coda,and my Rceree is in full force and effect
CrrNGC.NO.: GC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dale: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under panty of perjury that I am exemq from the Contractors License Law for the
tdlowi g reason(Section 7091.5 Business and Professions Code:Any ay or county whim requires a permit to construct.alfa.improve, PARKING REQ: P ROV: PARCEL: 42607123 Z N E: REF NO:
demolish.or repair any structure.prior to its issuance,eco requires the applicant for such permit to file a signed statement that he or she PLANNING NOTES>
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 >
7091.5 by any applicant for a permit albjeds the applicant to a civil penally el nal more then five hundred dollars($5OI). ******iN*********#***3E***1h9E*1N*****1N*1N****iN*****cit..E*1E******3*RE*#1N CE*******BE**1N******
❑ I,as owner o the property or my employees with wages as their sole compensation,will do the work,and the stmcture is not intended D EVELOPMENT S ER V I C E S REQUIR EMENT S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not applyto an owner of propend
who builds or improves thereon,and who does such work Nmself or herself or through his or her own employees,provided that such 1'
improvements are not intended or offered for sale.I,however,the building era: • - ens is sold within once yearoi completion,the ZONING APPROVED BY DATE:
}� ownerbudder will have the burden of proving he or she did not build• in. . . or the purpose d sale). n
u I.asownero the prepay.am exclusiveycontractiq with lice ... ..nU,•o con=iP. . .mjed(Section 7044.Business and BUILDING APPROVED BY : 7 DATE:
Professions
for TT �xiaaas th a ma(Law does
need t'e•••t •ntho Asa;rooreop�v-..buildsn or improves thereon and who (�
❑ Iemexempt under Section: B.SP.C.,Im ` APPLICATION ISSUED BY: y.4". ' to DATE: ���7
,.... L ******** E************IF ' l 4.j3.*a 1E iF 1f cE 1E 1E♦E 1N♦E*/0-27-93,-
.
* ♦F*1f♦E♦E div 1E
Dale: �D ..2 7-71" on �i/�f,. .�/
r LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N
Ido hereby certify that am aware di aro understand ill the not(circle Callon'i. and said m Code ate codessdons a requ 25599,and
ents lot
a perms'laothat
oonstmaioormcddficatiann frbuilding om the Aiu (enapembento�rvf.need��, y. with
�edrwon appE®g«w ereheemptfrom BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE SMIP/RES GRADING
proveions. PERMIT 43 . 00 ‘,/
Date: Applicant: / 25% If V' '. i,,_ SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby elf=wider penalty of perjury ale re the folow4N declensions: ISSUE FEE 20 . 00 e.-- '• 4,
❑ Ihave and will maintain acertificate domnmtose numbrwolden'coenpensaton.asproidedfabySsrim3700oftheLabor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
code,f«Ihepenmro
aadhew«kf«wxnmepenms.heaed. TOTALS----> 43 .00 20 . 00 0 .00 63 .00 63 . 00 . 00
❑ I have a and wmaintain workers'mrnpensaton insurance.as required d the nreqed by Section 3700 Labor Cods orlhe performance d the
work for which this penal is issued.My waken'compensation insurance carier1 policy. mbar. .:
Caner: REVENUE DIVISION TOTALS--> COLLECTED: 63 . 00 OVER/SHORT: . 00
Policy Number: —/II BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
TsTyhissectlonneednotbe completed Ameperms isfor one hundred dd/,�i�l 63 .00 - P-
[N I certify that in the performance of the work for which this peon'di
... any•.con in any manner so as to •' r / -7
becomesubpd to the workers'compensation laws d Calif. TTT 1�should .•?. . •bjed to the workers' *******1E3E*lf**********************1E1f**.************i(-*********lf****1E*1E***1E**1E*1E*1E*
compensation prwuom d Swan 3700 d the Labor cove, .h . .. . .
/ p o // / � e IND I V I D U A I ' 44 -Et BREAKDOWN
C> Date: 70 —2'- / APPlicanl: / aid, •{'
Warning:Failure to secure workers'compensadon coverage Is unlawful,and t an employer to criminal penalties and TYPE QTY DESCR IP T I O, N' 1 UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars(S104000),In eddldon to the mpensatlon damages as provided for In y
Section 9705 of the Labor Code,Interest,end attorney's lees. PLU 1 WATER SERVICE Nl 7 . 00 7 . 00
- CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of ••' the there is a construction lending agency for the PLU 2 GAS PIPING SYS OF 1' TO 4 OUTLETS 5 . 00 10 . 00
performance of the mirk for whim this wee is issued(Swbh 3097,CW.C). PLU 1 GAS SERVICE r' 7 . 00 7 . 00
LENDER'S NAME: PLU 1 BACKFLOW PREVENTER -.r ,' 7 . 00 7 . 00
LENDER'S ADD' SS: PLU 1 FLOOR DRAINS ,-:\ ' Ail 7 . 00 7 . 00
IceniN the le',read this••I,'• and statethal the above information is cones.l agree In campy with all city and county ordinances PLU 1 VACUUM BRKR/BACKFLOW'-PROTc.-' 1 TO 4 5 . 00 5 . 00
an•st el :no to builds' construction and hereby authorize representatives d the my to enter upon the ebove-mentoned propend ' END-OF•.-FEES
lli
on V ' AN SIMIDIAN '``.•' ,+ CjtC_ y_ (r19:i;S: TOta T
3T h3.
(Z1.AMP ltiAl Dee: / <, ....;.
•
\/�//1 I�iP tL/ / /0—17- t�
` , .pure d Owner/Agent/A•• IContrad«
1 (515115.WP) �hae-Bwldcp 6 Safety;Green-Fib:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor
+-r
' CONSTRUCTION AND PLANNING POOL .PA ---
Date
•Date Inspector Date Inspector
/ APPROVALS Permit# APPROVALS Permit #
1: Temporary Electrical Service or Pole 52. Pool & Equipment Location. ' -
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
73. :ElectricalConduit Utility-Undrgrnd. 54. Forms
1
-4. Electrical!edhduit-Undrgrnd. " 55. Electrical Bonding
: e. E- .-
5. Steel Rein+Qrcement 56. Rough Plumbing & Pressure Test
- - 6. Electricpt ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Fpotings4' '`-- 58. Electrical Conduit-Undrgrnd.
r i •
-8. Foundaiiiri• 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. -- ,..60. Backwash Lines, P-Trap,O-(lndrgrnd. •
10. StructurarFloor System .--��' 61.APPROVAL TO DECK --
11. 'Property Sewer Line & House Connection - - ./ •62. Backwash& Receptor-Final
12. Sewer Cap - ;- ; 63
. Heater & Vent-Final t'
*--i.:_-_
13. Roof Drains''7 _ 64. Plumbing System - Final . . •
14. Rough Plumbing 1 1 65. Electrical-Final
:w-
15. Rough Electrical-Conduit 66. Solar System-Final _ r,•
16. Rough Electric Wiring t 67. Fencing & Access Approval• •
17. Rough Wirifxg Sign 68. APPROVED FOR PLASTERING ,
tt;18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. :Rou'gh Factory Fireplace S': "`;_ -- 1 ` ~ APPROVh:LS_E Pepnit# "_., _
21. Ducts, irtStructurk r -• - - 70. VUnderg7oun'd hydro -
22. Ducts, Ventilating: - r'' - •- 71. Product Piping O Gas OOil
23. Gas ,ipe JRough & Test .. LI. . 7i . - 72. Underground Flush
24. Roof Framing • n< • , • -", 7; Undergrrld.Sto&ageTanlcDGas 0 Oil
25. Roof-Sheathin - - ,
9 -
74. Overhead Hydro
26. -T-Bar Ceiling (Structural) & Mooccoat - ` ' r 751 Dry Chemical ' ' T
27. Frae and Flashing, - -r- t o -v
m ^ r. 76. Dry Standpipe ..r.-i- - 1 _
•
.- 28. Lathing &Siding'- - - •' . •''; 777 FIXED SYSTEM-FrNAL 1r •-:
29. Insulation78:•FIRE PREY. FINAL 4 - - • -
y
' 30. Drywall Nailing , r , I -: _ •- ; -HEALTH DEP'. REQUIREMENT-
.
- 31. Plaster BrowrrCoat,1 -- -t - . '4 _ 79.LFINAL INSPECTION
32. Electricalfower Meter-Final •
8C FOOD CERTIFICATE IySS,UED
•.• 33. Fina-Electnc - Notes: /D-3G #?I:. E
34. .FinaLHeating'& Aic Conditioning- t _g d
) Gas Pipe-Test , ,' .. tours
35- Fin
%x-75 422JZ�t?
36. Hood or.Canopy • • a c- 41 ,
_ 37. Final Fagtory Fireplace - _ 2.
-k--;I 6.:0
: 38. Final.Plumbing j Z q - ?- _
-
39. Water'Secbice•Final. '' - :
=,40. Gas Service-Final +
-�41. Solar Domestic-Fina( -• _ = ,
42. Backf low Preventer . r' J c
43. Backf low Irrigation • - -,��
.44. Landscape Irrigation-System C' - - - 1
v -
45. Sound Attenuation _
46. Handicap Regulations i - •
47. FINAL STRUCTURE & BUILDING i '
48. FINAL PLANNING - -
49. Ele�ic Release to Edison = .
r -
50. Gas Release to Southern California-Gas - -Co - :
b9. CERTIFICATE OF OCCUPANCY •-
No Date
ADDRESS OF BUILDING: 218 22ND ST UMT: CITY OF COSTA MESA — BUILDING PERMIT
CWNERSNAMEIP@MWN: NEALON, LUCILLE PERM NO: B 074558
I ORE
ADS& 218 22ND ST
COSTA MESA, CA 92627 PERMIT NO: B 074558 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.MMLMIG ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: DEM
ARCHITECT ORENGNEER: UC.NO.: JOB DESCRIPTION : DEMO EXISTING GARAGE FOR NEW SQ FT :
ARCH.OR ENG.'5 ADDRESS: WIT:
CLAIM VALUE: 700 . 00 CALC—VALUE: 1, 000. 00 GROUP OCC : M-1 /
CONTRACTOR'SNAME
CONTRACTORS MAILING COMMENTS : DEMO EXISTING GARAGE FOR NEW /PLAN CHECK if 4058-95A
ADDRESS L1C.N0.: ******************************************************$************************
UMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury That I arra licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 d the Business and Professions Code,and my license is in full force and effect.
CRY LIC.NO.: LIC.CLASS: LIC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING
Dale: Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I ern exempt from the Contractors License Law for the
folbwig reason(Section 7031.5 Business and Professions Code:Any city a county whirr requires a pennh to mtarud.ager.improve. PARKING REQ: P RO V: PARCEL: 42607123 Z NE: REF NO:
lemotsh,or repel any structure.prior to its issuance.also requires the applicant for such permit to fib a signed statement that he a she
.licensed pursuant to the provisions c4 the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES> „(•
ausiness and Professions Code]or that he or she is exempt therefrom end the basis fa the alleged exemption.Any violation of Section >
]031.5 by any epplicam fadpermh sulMeds the epplitantmedwl penalty of not more than furs hundred dollars15500W ********************************************************************1(1Sjb***lE1E***
❑ I.as owner of the properlyormyernlNoyees with wages estheir sole compensation,will dothe work.and the sauduresnot intended DEVELOPMENT SERVICES R E U I R E M E N !'T S
or offered for sale(Section 7044,Business and Professions Cob:The Contractors License Lawdoes not appyloan owner of properly Q
who builds or improves thereon,end who does such work Iimsel or herself or through his or her own employees,provided that such
improvements are not intended or offered for sale.R,however,the building ori •• ,mend is sold within one year of completion, ZONING APPROVED BY '•)
owner-bolder will have the burden of Proving he or she did not build or imp. ,'• the purpose sale). DATE:
❑ I.as owner of the property.am exclusively contracting with licensed cont: .construct t roped(Section 7044,Business and '
Professions Code:The Contractors License Lew does not apply 1• i• • . • popery �' • ins a improves thereon els who BUILDING APPROVED B Y DATE: /' '-
contracts for such prgects with a contregor(s)licensed pursuant • C. ere 4. ). /
❑ Iamexempt/under Senbn: B.AP.C.,fotH. .�:j�. � �/ 4 APPLICATION ISSUED BY: • DATE: 1 b• /4/ -9s
r Date: !f/ -��-1C Center:
/u'/. L : — 3E1EiEiEiEaE3ElE****iEiE{EiE%iEiE3EiEiElEiEiEjEiEiE#iEiEiEjEdE3E****-%iE#*** rE3E9E-IEiE****jEiEjEiE3E**A3E**1EdE*471 **
y r LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y
Ido hereby certify Thal I am aware of and understand the requirements of ellomie Safety Code Sections 25.505,25533,and
25534,and that I or any future building occupant will/wilt not(circle one)need to $h saidcodes and the requirements ler
a permit to construction or modification from the Ar Duality Management District.R.:'•andel costuctsn sanitation,are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES] GRADING
provisions. PERMIT 25 . 00 ”' •
•
Date: Applicant SMIP/NON R E S
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: PLAN rj Q '
❑ Ihave and wilmaintai.acerldateofconsent toeafinsuefor workers'compensation•asprovdedfor bySecion3700ofthe Labor ISSUE FEE
Code.for theperamanceo'heworkfowhichthispermhaissued. BUILDING DIV > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE
❑ I have and will maintain workers'compensation insurance.es required by Section 3700 o4 the Labor Code.for the performance of the
TOTALS > 25 . 50 0 .0 0 0 . 00 2 5 . 5 0 25 . 50 +_ 0 0
work for which this permit is issued.My workers'compensation insurance carrier end policy number we:
Carrier: a REVENUE DIVISION TOTALS--> COLLECTED: 25 . 50 OVER/SHORT: . 00
Polly Number: _—/ BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I This section need nor he completed 1 the permit is for one hundred doll .,25 . 00 . 50
a I ernes that in the performance of the work for which the permit : all not ,d •.• any pemon in any manner so as to
become subject to the workers compensation laws of Cal Nom. that . cold become subject to the workers' jE. •M.N.iE*.1f*3E*IE*.1EiE*.x..1E3E*.)F.IEiFiE.1E**.x.*.**.K,.1E.)E.*.N-.If.)E.1E*.K..1FIf.1EiE*.N..H,iElE.)F,K.1Eif.K,3E,1E.lE.7E-0E*1EiEiE3ElE,)F*iE**�E#,1F->E****;£,
aapensenen previsions of Section 3702.21_10 Labor Code,I s :* „,/, A' osis p•. ions.
.l /b—I ; _n "r INDIVIDUAL F E E BREAKDOWN
1 Date: rApplicant:
WarnIng:Failur,to secure wo.*eea'gomper'aarlon coverage is unlawful,and rJettenemployer toadmne:penareesand TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollars($f00,000),b addition to the compensation,damps as provided ler/n
Section 3706 of the Labor Code,Interest,end atiomeya feet
TEES WERE SELECTED FOR THIS PERMIT .,
• CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that(here is a constmdion lending agency for the
Performance of the work for which this Venni is issued(Section 3097,CS.CT FOR
LENDERS NAME:
LENDERS ADDRESS: 1M
I certify that I .ad thisapplication end state that the above information is correct. agree to complyr•1 `' .r1% r
and ret -burs this with all dl and countyordinances / �� �•7
g to builds•construction end hereby authorize representatives of dry to enter upon the above-mentioned properly ///e
for in • .o .,. y CALL �I���,4 0'
V-:BAN SIMIDIAN 754-5626 r/'� V (Andi� �4•: •
���,�'/ a Pdnt : . 7 0 01 00172Y;: -3;1927r -'-73-r
i/��l/!/%�` — Dam /O —a-/� or CF1'iE; ,Y.,.. j. E 7'7 7.5.Y.,
• I r. .c urs of Owner/AgentApplicant/Contrador !.i
` 754-5627
Ad(5151-48.WP) White-Building&Safety:Green-File:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor ,
CONSTRUCTION AND PLANNING POOL ,PA •
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit# - - -
1. Temporary Electrical Service or 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. - -T 60. Backwash Lines, P-Trap, 0 Utidrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection i' 62. Backwash & Receptor-Final
12. Sewer Cap , 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
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#
X11•
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 D Gas D Oil ,•
25. Roof Sheathing 74. Overhead Hydro ( ,i
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' I .,
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: f
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test • ;2'7?
36. Hood or Canopy
37. Final Factory Fireplace =vyr
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 ///''' /_-�ff .-z
47. FINAL STRUCTURE & BUILDING Z Cl 4T- L• _- _ /J n �
48. FINAL PLANNING C� 76 `qwv' OQl/
49. Electric Release to Edison /V7
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
VELE
I MI
RECCIVED
C. J. L I G H T CITY OF COSTA MESA
ASSOCIATES BUILDING DIVISION
MAR 1 3 1996
March 11, 1996
Mr. Tony C-De Baca
City of Costa Mesa Building Dept.
77 Fair Dr.
Costa Mesa, CA 92626
Dear Mr. C-De Baca,
It has come to our attention that our firm, C.J. Light Associates, has been named as the
architect of record on building permit numbers B74558 and B74804, relative to the
remodel/addition to 218 22nd St., Costa Mesa.
Our firm has had no association with this project in any way. Therefore, any reference to
C.J. Light Associates as the architect of record for this project is completely incorrect.
Please remove from your records all references as C.J. Light Associates as architect of
record for this project.
If you have any questions, or require additional information,please call me.
Thank you for your assistance in this matter.
Very truly yours,
C.J. Light Associates
C.. ( (1111-6
James R..I Light
President
1401 Quail Street, Suite 120, Newport Beach, CA 92660
(714) 851-8345 FAX (714) 851-1116