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Home My WebLink About233 22ND ST - Building Permits7 . • -- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA�MESA COJ�TI /vR T f PERMIT NO. TRACT NO. WT NO. UNIT NO. 32�5 9)I �I-86 project liddress ,6�/� l.T. 'L� 3S� -ru�CY07,a 83 t _ _ 241 e�2 TL Applicant•rMoiling Address _�_�__/Y atesi5,/ amp. 10/91 TYPE OF CDNSTRUCTjQN U NEW DO)(ALTERATION Li REPAIR Y P � ❑ CONVERSION a DEMOLISH OTHER'/l y.�J Owner's Name / Phone - _ IC 1eefrfo�raL/ A.P.A # HC210 - I -Ds Zone / DF,SCRIPTION OF 45 jK/US F BLDG. ' S Main Building: Accessory Building:Address /�r 5TION 2SK. / eL}7M a��1r'�wJ Arch/Eng. may' Q_�,/��y License No. `/ ' Q TYPE OF PERMIT L I GRADING LJ FOUNDATION U STRUCTURAL T Front Q '7 O yAdddreesss _ ./ ��}�r(p ,�� ^'�� -SU�IPI� r/. LI TENANT ❑ ELECTRICAL LI PLUMBING LI MECHANICAL B Rear / N Co dtfacto s Kamp aJ+' /7�� Phone? 3' LI 'OTHER D Right N Address(mailing) i Oa I *)Q� 7siluepJ, FR �,0.k-A txT/ PROJECT DESCRIPTION Sri. oceuPAN1c�Y( K / �ha CONSTRUCTION TYPE VALUATION $ L t i S Left G City License No. /9 �� S ZONE GRADING CU.YIDS. O ACRESE- LICENSED CONTRACTOR DECLARATION ////' Ping. Ref.# Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: .f C'• C 1 //Ds 8z. fa 6/`06 Planning Notes: . M with section 7000) of Division 3 of the Business and Professions Code,and ( s� (a my license is inJ/yll force and effect. - 7/0��c C �ZD d S S {I�0 Licens Class -/ License No.4 Date g Y 12 Signature 2) .r.,44.. ' PLUMBING FEES N. WORKERS' COMPENSATION DECLARATION . Bar Sink Showers ELECTRICAL FEES O ' '-ereby affirm that I have a certificate Of consent to self-insure or a Certificate e_ Yorkers' Compensation Insurance, or a certified copy thereof (Section= \ 0, Lab. C.) - Backflow Preventer Servide Sink Automatic Washer• Transformer ❑ 15-50 KW PolicyNo. OCe39 SL//GCA .Com an nN.r}L"F� Backflow Irrigation Sewer Cap0 50+KW �s, Company ,- 9 •,•, Construction Pole Sub. Ip Certified copy is hereby furnished:- n �d CerL ietl copy is filed with the city BLLl�d ing pivis)'op Bathtubs Sewer Connection p 00 Cooking Unit '/ Meter ❑up to 100 amps 7 co Date 5� /7 applicant ' ./7 ,f— /') t.c� EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - / Dishwasher Meter ❑over 100 amps DD (This section need not be completed if th Q'permit is for one hundred ($100) or • less). - / Dishwasher • Solar Piping 2 a, ; Dryers DGas ❑Electric Sub Panel I certify that in the performance of the Work for which this permit is issued,.1 /� snail not employ.,any person in any manner so as to become subject to the' Drinking Fountains Solar'Tank • - Fan -Motors❑0-1 HP RKI-8 L QQ Workers' Compensation Laws of California. • Date Signature Ftloor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+' NOTICE:If,after making this declaration,you should become subject to the -L J Workers' Compensation provisions of.the Labor Code, you must forthwith Floor Sinks ' Urinal /2 Fixtures __. t' 2 comply with such provisions or this permit shall be deemed revoked. - _ Microwave [C CONSTRUCTION LENDING AGENCY Gas Service Outlets 7 Water Closet - 2 QD Device BoxESr ' r I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C') Interce tors .- Water Heater ' - 7 9.n Lender's Name ` ,D �/�^! .` ' per— _/6 Outlets' Range J Imo✓ Lender's Address IV F- CMM"-' , Kitchen Sink Water Service 2 fes, Switches 1 Sign / ‘O OWNER BUILDER DECLARATION ` I hereby affirm that I am exempt from the Contractor's License-Law for the / Lavatories _ Auto-Wash - / Z QO / Garbage Disposal t ;Standing Sections Co following reason (Section 7031.5 Business and Professional Code: Any city or H county which requires a permit to construct,alter,improve,demolish or repair - P-Trap , Trays ' Generator 010-5 KW ❑5-15•KW Trash Compactor 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 (Chapters (commencing with Section 7000)of , ° • • • Division 3 of the Business and Professions Code) or that he/she is exempt s 1 'from and the basis for the alleged exemption. Any violation of Section - .5 by any applicant for a permit subjects the applicant to a civil - sn - .ilty of not more than five hundred dollars ($500). - - r Reinspection Fee $ 3 ' ❑ I, as owner of the property or my employees with wages as their sole P $15, Issue Fee .. compensation, will do the work,and the structure is not intended or offered - - • •c Reinspection Fee.- "'I $15 Issue Fee' $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's • - . MECHANICAL FEES --_ - _ - License Law does not apply to an owner of a property who builds or Improves _ I. thereon, and who does such work himself/herself or through his or her own I Hood or Thine I ❑ DEVELOPMENT-SERVICES REOUIR(EM�`E�1�T yJ,� /) employees, provided that such improvements are not intended or offered for Boiler yp • Zoning Approved By " • /t/�( L/�.A-lr/ Date //�• sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ rt2 pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved Byar 8•M. Date rove for the rpurpose f oe). - •- Vii— il f ice �� I, rs o of the property, Se exclusively contracting with licensed con- Duct-Structural Refrigeration System _ Application Issued By-43" •' Y7—Date *actors 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 ❑0-100,000 BTU ❑100,000 BTU - . • .. } - SU MARY OF FEES builds or improves thereon,'and who contracts for such projects with a con- _ _ ^ / . proof license pursuant to the contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING'PER MIT $' 1 l7.SD SMTP $ !. 7,2.- Date Z proof off their Worker's Compensation insurance should be provided to me. PLAN CHECK -$ ' PERMIT ' ❑ I am exempt under Section B. & P.C.for this reason Fire I/Fact.Blt. ICBG#/S8 Fire Dampers 1 • p 3 p PLUMBING • $ - 1?sem .ISSUANCE $ Date Owner - • , Heating System& Ducting —...7 Registers 7 ` PLAN CHECK'''. 25°[0• $ 2.SO ENERGY P.C. $ I hereby certify that I have read this application and state that the above Lr0-100,000 BTU ❑100,000BTL ` GRADING $ ' information is correct. I agree to.comply with all city and county ordinances /'ELECTRICAL" $ and state laws relating to building construction, and hereby authorize repre- - 3�� PLA N'CHECK�50°f $ 11;.1%1° MICROFILM $ • sentatives of this' city to enter upon the above-mentioned property 'for i inspection purposes:� ,G (� i/ cat ) 1 y/ MECHANICALt , $ iy` Se TOTAL FEE $ �� \ Signature /' I //is4 Date /7 Kx ,L Drivers' License or SS# - ! _ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ �s CO _ 2'f/.Q2 F 0665-46,rev.10/134 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor • i CONSTRUCTIONAND PLANNING POOL ' -IDA Date Inspector Date Inspector r' ^�.:>PROVALS Permit# APPROVALS Pernnt# 1 '.temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. SoilPipe-Uridrjrnd. - /0/174 Aer53. Steel Reinforcement 4 3. Electrical'Conduit Utility-Undrgrnd. 54. Forms • 4. El'ectricalConduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - ' 6. .Electrical UFERR Grnd. 0 57. APPROVAL TO COVER-GUNITE • 7.,Footings- T.S . C (p 4i� 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/7/dl 00 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection / `/ _ 62. Backwash & Receptor-Final 12. Sewer Cap ` _ 63. Heater & Vent-Final 13. Roof Drains` ' 64. Plumbing System - Final 14. Rough Plumbing 1/i /� 'fit 65. Electrical-Final • . 15. Rough Electrical-Conduit / ��` 66. Solar System-Final _ 16.-Rough Electric Wiring /--) '25 F7 / / ' 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 .e 71. Product Piping El 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 /09840 Pb 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 I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 179. FINAL INSPECTION 32. Electrical Power Meier-Final. 444-7 I e_,/ 80.; FOOD CERTIFICATE ISSUED 33. Final Electric /44-1-2V Notes:` 0 3o 4 ert _,_0 06• 34. Final Heating &.Air Conditioning Cf-ty 441) . 'tf 7 6 - S , j 35. Final Gas Pipe-Test Biel 06C- VD WA�t44p D& 36. Hood or Canopy 21 87 5to..-a Ic (O ¢.4L (tvi 1 Tot mi- 37. Final Factory Fireplace - 0 ] -3S-f7 Chs�� Ga,-v, c ,11oa_. r' f cm.- 38. w38. Final Plumbing 4-147 LEO a' 39. Water Service-Final , rk40. Gas Service-Final LIJ�/y1_I�QI o 9 - 41. Solar Domestic-Final ((// 42. Backf low Preventer . ' 43. Backf low Irrigation - ' Pi! 44. Landscape Irrigation System , 444 45. Sound Attenuation 46. Handicap Regulations ••,,// • 47. FINAL STRUCTURE & BUILDING `00 / j oe1- 48. Special Requirements Completed ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co i• , 51. CERTIFICATE OF OCCUPANCY - No. - Date _ - ' Applicant to fill in all spaces except those border lines and sign all appropriate declarations. • CITY OF COSTA MESA CONSTRUCTION PERMIT I PERMIT NO. TRACT NO. . LOT NO. UNIT NO. F775 '1 1 /05/86 15,00 TL Projact:✓?dress ,2 . 2 Z,vP r 5, ^". Cr 2A-3 St - [CI ,y ' . Applicant's Mailing Address j/'9/J -C y''t l c O/ TYPE OF CONSTRUCTION ' [C NEW LJ ADD Li ALTERATION LI REPAIR ( 419/9g-ii ZE,CV/� Phone e:w —net,' ❑ CONVERSION 0 DEMOLISH 0 OTHER A.P.# Zone Owner':Name 6� DESCRIPTION OF WORK/USE OF BLDG. I ( Address 2 : 3 "L'2- r' C, r S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING a FOUNDATION thTRUCTURAL E Front 0 Address 0 TENANT 0 ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name /11$1/ (i1Ntr Phxte 777"-ei79 0 OTHER A Right N Address(mailing) ��9�2' /1/4.0.5/9-4/7 ,i-le PROJECT DESCRIPTION SQ. FT. OCCUPANCY .9--.15-4•-• K ' G C CONSTRUCTION TYPE rn�t " NPP VALUATION$ S Left City License No. 347 /4 ZONE GRADING CU.YIDS. ACRES R LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: Q • with section 7000) of Division 3 of the Business and Professions Code, and _ M my license is In full force and effect. n S License Class—B. — _ Licens No. _ Date /a-/'t/. 'CQ�Signature' .. �A PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate _ ELECTRICAL FEES ' 'of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink - 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. a c—Q 0,9 -ex. // Company l7f./a L/CC` Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW Certified copy is hereby furnished. — Ce. l;p cgppi filed with the cit I n Divif/Act„etc Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date, R y ApplicantRS' EXEMPTION FROM WORKERS'C MPENe TION DECLARATION Clarifiers Solar Collectors _ Dishwasher Meter Dover 100 amps (This section need not be completed if the p rmll is for one hundred ($100)or less). Dishwasher Solar Piping , Dryers ❑Gas ❑Electric Sub Panel I certify thatm in the performancepersonIn the work for which this permit is issued, I • shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1'h-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. - NOTICE: II,alter making this declaration,you should become subject to the Inc.Solar 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks UrinalFixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance 9 ' of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Range Lender's Address . Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION • Sign I hereby affirm that'l-am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following'reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections county which requires.a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑45 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor 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 . - •herefrom and the basis for the alleged exemption. Any violation of Section . 031.5 by any applicant for a permit subjects the applicant to a civil • ' 1 alty of not more than five hundred dollars($500). CenI, as owner of the property or my employees with wages as their sole Reinspection Fee . I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered 1 - Reinspection Fee I $15 Issue Fee $ 3 for •sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves _ _ _ _ ___ thereon, and who does such work himself/herself or through his or her own — DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale. If, however,the building or improvement Is sold within one year of com- — -- - -- -- Canopy Type II ❑ Zoning Approved By Date pletion,the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). ill ,��-� ❑ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By Dat: i 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 ❑100,000 BTU �QM - builtlz or improves thereon,and who contracts for such projects with aeon- /•---”" `5 SUMLMA�R V.OF FEES tractor(s) license pursuant to the Contractor's License Law). am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDIN PERMIT $ / Il QJ SMTP $ proof of their Worker's Compensation.insurance should be provided to me. PLAN CHECK $ P • 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers PERMIT ERMIT ISSUANCE $ PLUMBING $ Date Owner - Heating System& Ducting 'Registers PLAN CHECK 25% S ENERGY P.C. $ I hereby certify that I have read this application and state that the above 04100,000 BTU 0100,000 BT GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating-to building construction,and hereby authorize repro- $ MICROFILM $ sentatives of this city to ' ter upon - above-mentioned property PLAN CHECK 50% Inspection O.. '/ ' • Signature r - �`Ist—� �� Date-C/7/1/44 - — MECHANICAL $ -_ TOTAL FEE $ !s--.00 Drivers' cense -r SS# 10 Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ =CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting;Goldenrod - Assessor . - CONSTRUCTION AND PLANNING POOL&SPA 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 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 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 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# - 21. Ducts, in Structure I 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑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) & 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 • 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 I 1 • 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46: Handicap Regulations 001 • 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co f' ' 51. CERTIFICATE OF OCCUPANCY No. Date . • \ I Applicant to fill in all spaces except th e within heavy border lines and sign all appropriate declarations. cITV OF COSTA MESA CONSTRUCTIONPERMIT PEE$��RT NO. ✓ I TRACT NO. LOT NO. UNIT NO, 3467 9/ 19/86 8.00 TL Protect address 9 3 9,Ato ST CoL5-to An ES/i ` A r c/ 44( ' ' // j t� 's TYPE OF CONSTRUCTION U NEW ADD U ALTERATION U REPAIR Owner's Na Mailing Address OE•� a-c' Iisti" Woo n L , f`' ❑ CONVERSION ❑ DEMOLISH ❑❑ OTHER — A.P.f # I Zone Owner's Name ,a 12.E �F/11V� Phone/LW, ��%>7 DESCRIPTION OF WORK/USE OF BLDG. Address '.1)-^m'`O ti T S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMITss�� ❑ GRADING ❑ FOUNDATION U STRUCTURAL T Front ZO Cc'✓$T, / ❑ TENANTa ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B N Address // p �/// //s/ CI OTHER A Rear slot/ C�6/ r,! C/nv/ z" -P5•574— Contractor's Contractor's Name Phone -�.7!-O�Sf • C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address(mailing) ose N g) CONSTRUCTION TYPE VALUATION S S 3 K Left City License No. 1 4FS R ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E 1 hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: T , ' q "0� /_3_ol fE /'_ - Planning Notes: 0 with section 7000) of Division 3 of the Business and Professions Code, and M my license is in Al tie and effect. •� T License Class LI ��rr ense No. � 7 co e'-••L5-3 679 S Date >-4-774"./.9 Signature "Tr-/4-741-4/ PLUMBING FEES , WORKERS'COMPENSATION DECLARATION Bar Sink Showers 1 hereby affirm that I have a certificate of consent to self-Insure or a certificateELECTRICAL FEES f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 800, Lab. C.) _ - -_ . Automatic Washer Transformer 0 15.50 KW Policy No. /ti-Sit.. -1 -s<</Cc:/4 E" 4 G e%FE Backflow Irrigation Sewer Ca 0 50+KW P - Construction Pole Sub. Certified copy Is hereby furnished. _ - Certi ed copy Is filed with the city Bud in Djvisio , Bathtubs Sewer Connection ,Q 9 Cooking Unit ' Meter Dui)to 100 amps Date .ate- i 1 ' Applicant z,/ /� _ • Clarifiers Solar Collectors EXEM PTiO FROM WORKERS'COMPENSATION DECLARATION Dishwasher Meter Dover 100 amps \.......„ (This section need not be completed if the permit is for one hundred ($100)or • _ less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel N. certify thatm in the performancepersoninof the work for aswhich othis permit is issued — shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Workers' Compensation Laws of California. Motors❑Ol HP ❑1'/x-8 Date Signature Floor Drains Swimming Pool w/Spa F.A.U. NOTICE: If,after making this declaration, you should become subject to the Inc.Solar ❑915 HP❑1B-1$+ Workers' Compensation provisions of the Labor Cotle, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes • I hereby affirm that there is a construction lending agency for the performance ! Pole Light • of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heateroutlet$ Lender's Name Range • Lenders Address - Kitchen Sink Water Service Switches ` - Sign - - 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 Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-$KW❑5-15 KW any structure, prior to its issuance,also requires the applicant for such permit Trash Compactor 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 _ - _ I • • ' vision 3'of-the Business and Professions Code) or that he/she Is exempt _--- - • -+*erefrom and the basis for the alleged exemption. Any violation of Section —^' 777 „°.131.5 by any applicant for a permit subjects the applicant to a civil / �A9.%y-• ttell'f/7 .-c--- 7-- (I7) ,4nalty of not more than five hundred dollars($500). / LI I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee • $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 • for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL L FEES • License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such Improvements are not Intended or offered for Boiler - Hood or ' Type I 0 • sale- If, however, the building or Improvement Is sold within one year of corn- Canopy Type II 0 Zoning Approved By - 'Date pre the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date=_`' ' prove t for the purpose of sale). y ❑ I, as owner of the property, am exclusively contracting with licensed con- . Duct-Structural Refrigeration System Application Issued By_____ _C..- Dat 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 00100,000 BTU 0100,000 BTU . SUMMARY OF FEES - builds or improves thereon, and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP . $ ' proof of their Worker's Compensation Insurance should be provided to me. - ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# ' Fire Dampers • PLANPERMIT — PLUMBING CHECK $ I$ -PEERMIT $ Date Owner - . - Heating System& Ducting Registers - $ ENERGY P.C. $ PLAN CHECK 25% I hereby certify that I have read this application and state that the above ❑0100,000 BTU 0100,000 BT - CCJJ GRADING - $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL .$ d� • and state laws relating to building construction,and hereby authorize repre- • • PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for - �� inspection puregSes. F J�� MECHANICAL $ Signature S r//ii-.7 y p $ CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 47.4.1.g. /9 , 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 COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 8. Foundation 59. Gas Pipe, El Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 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# • • _ 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) & 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 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 - 48. Special Requirements Completed 49. Electric Release to Edison a 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date 4 City of Costa Mesa INSULATION CERTIFICATION Building Safety Division 2 5 oC tAC) SI (9onFs4— LY Number and Street City Subdivision Lot Number DESCRIPTION OF INSTALLATION • Mat Brand Name Thickness (inches) Thermal Resistance (R Value) EXTERIOR WALL Material .oils Brand Name 6324.1 -0 Thickness (inches) Thermal Resistance (R Value) .e"/� CEI LI1 " ger Blanket Type G Gd �� Gds Brand Name (,�� /s^^ I/ Thickness (inches) to Thermal Resistance (R Value) �" 9 Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags Weight per bag lb. Area Covered (ft2) Thermal Resistance (R Value) FLOOR, ELEVATED Material Brand Name Thickness (inchesL Thermal Resistance (R Value) FLOOR,SLAB • Material Brand Name Thickness (inches) Thermal Resistance (R Value) Width (inches) FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance IR Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). • 7V/9i/ r7.,/vsTYvOn0-O VOO '7 5-Z) General Contractor(Builder) License Number re-ver-Lc--i fr"PP- 0 $7 Signature and Title Date Sub Co. - . nsulation Applicator) se Number Sign: - .nd Title ate CMF 1106-46 COUNTY OF ORANGE BUILDING DEPT. • 31 ebe 636 No.Broadway Permit Na Santa Ana,California Application for Building Permit t Phone:KI 2-6211 AND FOR A Certificate of Use and Occupancy /-7 Date • 1. OWNER'S NAME 31.s et . _0...M...6.a R DJ PHONE- • MAILING ADDRESS....3...5n ,L -2 r- g Ni . 14/17CITY !ZL%fl.8 'ei/rT 'L Name Name _6'-et.hrrOSi 88 OS , (Architect or Engineer) �^ r t (Contractor)�/� /�'' ,� Address Address /.2t,1 - ...Acre, 1, ..' . ec City City State State // / Lic. No • Phone �+ (� Lic. Nu l/ Q'�'/ Phone by-63't r PROPOSED USE- ,4.a..J_i'-i-t '-`y-- Ce—S.._\ ----....C...-i.fee // . 2. JOB LOCATION e2-g..3t2c )"Ist'. ess. ,-,74-0-02-0.- • (House No.) �j (Name of Street) (Town or School District) jJ �/ 3. LEGAL DESCRIPTION: Lot 83 Block - Tract.]>" I • !I • (Metes and Bounds Description—Use reverse side of form) 4. CORNER LOT ( ) INTERIOR LOT ( ✓) THROUGH LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF BLDG.:./0 X 41 AREA•oa 9. SIZE OF LOT:_7-�(..�7f AREA:2 t 42 mar 6. HEIGHT OF BLDG - /1 CEILING HEIGHT:, NO. OF ST IES aexco 7. NO. FAMILIES Size of Smallest Bedroom- Size of K chen.J.QX_(,. e ).- 8. EXTERIOR WALL CONSTRUCTION- k- U!. /A g INTERIOR WALL COVERING (Frame, Stucco, Etc.) / i (Plaster-Drywall, Etc.) 9. SETBACKS: Front Yard From Center Line of Street_.el i••••••'-, Nearest Side Yard '7 Rear Yard /q6 t Distance in Feet Between Bldgs. on Same Lot 10. A COMPLETE PLOTISI QbIRFI],S NG ALL STRUCTURES AND USE OF EACH. 11. For (a) Foon g: Width-y-j..j./,C Depth in Ground..�.,0- Width of Wall AccessoryBldgs. / Simiilarand (b) Size of Studs:.s .X_l Spacing /6'I "CC Material of Floor 6s4r /t[ Structures: / (c) Size of Floor Joists Spacing Spacing "CC (d) Size of Rafter Spacing 2 \I. y "CC E 12. VALUATION OF PROPOSE 3JORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $.JaZQ 0 \` 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• ��id( wnerrectr0) ' "' "". Plans Filed. / fin :a/(��- By. (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: �E K BY Bldg. Permit - $ Jfj GROUP �/ APPLICATION- .:ef /HEALTH Plan Check - $ f U. TYPE ZONING FIRE Total - - - $ -C!DIST. / i PLANS AND MARSHAL • Receipt No. 0. 4 {� MAP SPEC'S STATE Paid to - - t.. t SHEET NO CORRECTIONS ENGINEER Date S/.J?44.C.. VERIFIED �f ' COUrN PCAL PERMITGS W!4NOIIU CCTORING . ., DATE /(/l r� i��'//�% l k• ' It!EPVTY . 5 M-B-5I ///////A//✓/ OWNER COLEMAN, A. E. free DATE 7-20-54... .. . , JOBADDRESS 233 E. 22nd Street BUILDING PERMIT NO. 405 GENERAL CONTRACTOR Owner-Builder VALUE $ 900.00 Lt 'P#118-110-17 BLOCK TRACT Garage GROUP J TYPE V ZONE Rh FIRE DISTRICT #417 PERMITS ISSUED INSPECTIONS E/ SUBCONTRACTOR DATE NUMBER C- /// • Footing Trench Foundation Forms and Grade to Gar ge _�/ Rough Framing —/tQ- (7are. Plumbing,Rough to Slab—•-\ Plumbing, Rough Complete Temporary Pole Wiring,Rough • 6-Xja Heating,Rough Heating,Final Sewer Septic Tank or Cesspool La' I PIs .Ing Plumbing,Final,Fixtures Complete Plumbing,Final Gas Test '� 1 Wiring,Final nr tiCJ' ' Ar/Occupancy 1 . .2 k'>! •-a�_ Form 210 G-H IDI 12-59 'Acosta Mesa Building Department APPLICATION FOR PERMIT COSTA MESA /-1 is 111 EAST 20CALl Oth ERNIAET •�J BUILDING 1 FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN c p N Permit N= Building ' jj ..2.2 n-11 I 3 �G S Address ./ ? ,.2 /✓�G Costa Mesa, California Received by Date Recd. Date Issued Nearest - 7---ye 'Cross S _/ e. Building Address % 33 ) � Owne -Q !� ei - 'r/ Costa Mesa, California Mail Address . `.i 72lI a.f/ Seeks Nearest . Tel. Cross St. t City 2 33- E .. .7 No. Zone �I No.of I Type v Group Architect or Lic. Plans • (/ Engineer No. Approved by �" - Date?—0.4—w .dress ORRECONS wage City Lic. ..ontractor No. — Address - Legal I Lot I I Description No. Block Tract (Attach Metes and Bounds) /18" /to ---17 No.of Bldgs. pantoSize of Lot 7� X 2� I NowonLot O Use of No.of / No.of ,/ A Existing Bldg��gn,Uc_. I Familie& I Rooms" 6 Setback Line from Rear Yard 2_51 Z, Center of Street Side Yard J U L 2 01954 D DESCRIPTION OF WORK - - - r New I X I Alteration I I Addition I CITY OF COSTA MESA Repair I I Moving I I Demolish I Building (/ No.of sizery i Rooms Stories I erior Wall . Roof vering w(9 O17 I Covering c-o r'? APPROVALS Use of New r1 Building (jr...,,rd .... /Y1/1**- J, Foundation Location Inspector DData yV� Under- innerials, ` a . / c ��(]]]////// Under-Pinning (ALL j7 / Frame:• Brag,BStops, �/L •/L �� Bracing,Bolts ``'. �tN� I hereby acknowledge that I have read this Application Lath. Int. N O � and state that the-a.'• is .rre.. : d agree to comply �f with all City 0 .' ance• Jand t- e Laws regulating Lath. Ext. tun n Alabuilding constru. ion. Signature of - /` / Plaster, Int. �ELQ Permittee �rr.�-1"ei..6_,.it/ ti(� Ake Plaster, Ext. Authorized Agt. ' / Masonry Reinforced 'UN Q - Valuation Permit Fee-$ 00 r_ 8 ALt Plan Check $ Bond Beam \7/44- _ y/ $ 7� al Fee $ **4 / �oDO FINAL k :.Y 0 C c d J O rV V d Fry 4* i 7 2 �0 - A...4- Street '1) '. . .l r - 'b M`p PLOT PLAN Sr“: .;o, ; :1 and'distancea 1 ".1 property line and between buildings. - / . IY _,,..,, r",,,.:...yy eyr,e 's Compensation_ �.:°-� fr��.bre'f . Yes ri - . .No - - aurora a o3 Provision 3700 of the Statii; 'Eseiber,code which requires every employes to me lured ag.a sap, lability. ff wor1n s .mpe.,. . Pro 9 Signed: ell r+ OWNER COLEMAN, A. E. - DATE 12-31-56 JOB ADDRESS 233 E. 22nd Street BUILDING PERMIT NO. #4170 GENERAL CONTRACTOR Owner Bldr. VALUE $ 672,00 L AP112830-17 BLOCK TRACT StDr3ge & Laundry AS PER U. B. GROUP ,T TYPE V ZONE R4 FIRE DISTRICT 4215 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR Q ' DATE NUMBER Footing Trench rte£% /.2 f Foundation Forms and Grade to Garage �y Rough Framing • r :Sr pCLt_72cL.Lfiirvca. /1. / Plumbing, Rough to Slab /;.e-fes ,..fr_p�r,�. Plumbing,Rough Complete Temporary Pole Wiring, Rough Heating,Rough Heating,Final Sewer, House Sewer,St. Septic Tank or Cesspool I .ng, In Out Pi—tering Plumbing,Final,Fixtures Complete /2 ..f. i Plumbing,Final Gas Test —��'� Wiring,Final _ Occupancy FORM 210 3M 10.55 4170 Ilosta Mesa nmtamg Department P'ulc rEitciru''i. A P. O. Box 3!7 a'�7� 5 BUILDING COSTA MESA, CALIFORNIA " FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. Permit No. Building 4 7 02 z - t 2. Q/F- 47j7o Address .!J ✓ �T� Costa Mesa, California eceli, Dat Rec' Dat ss Nearest Cross St. }'} i /: / i Address r.[.Own � � �� ` Mail �/ Costa Mesa, California AddresssZ�,3�f3 — 6 2 / Nearest4:2e/ City 1 .f+�c`— (J Nell., a, , CrossZoneSt. / NoGroups Architect or Lic. P 7 /�� Engineer No. Approved by Date adressi _ ORR CYTONS City Lic. I� ate Address r o >r Art,79 en, LegalLot 1 /.)^f aftae_er Description I No. 293 I Block I Tract // Q / 7 Sc.'a/ ISS -��P (Attach Metes and Bounds) //O I/ 1 7 �7. .eC No.of Bldgs. ,.-., Size of Lot 7� X ,j 7.) I Now on Lot Use of �(c».�-z• I No.of I No.of Z 3. 4 , Ara" 33 Existing Bldg. Families Rooms/ �, Setback Line fr m Rear Yard/Ft-9,, r 2 Center of Street • Side Yard ,7 ' f, 9"'1n >1Di1 7 DESCRIPTION OF `VORI ..S ate+ w . CITY nc CCcT^ 0. MES-t New I Alteration I I Addition I^ PL/1Nhi,Nir rbJ nT- BuBJECr TO BLDG. DEFT. R Repair I I Moving I I Demolish I rn Building '! No.of n �Ize k 7 i I-7 Rooms I Stories I :atria _ erior Wall y Roo ~ ✓ering v-o-�� I Coy f . • d. !/_f.v OVALS Use ofdi New Foundation Location Inspector Date ' Building '/ Forms,Materials, 47K n, fes, --,^, ( dr Under-Pinning J '�'� Frame: Fire Stops, Bracing,Bolts 03 I hereby acknowledge that I have read this Application p and state that the above is correct and agree to comply Lath. Int. O with all City Ordinances and State Laws regulating - building construction. Lath.Ext. At Signature of Permittee Plaster, Int. - Authorized Agt. ". Plaster,Ext. O - Valuations 066nt Fee $ q�/r Cd Masonry Reinforced I7 O r C$ BondBeam $ 0 $ V FINAL 0 OIMMr FORM 204 1055 O.P.&S. 1b 1 c 0 J Ji d. a. 6 0. , • • 1, • • • . . Street -- PLOT PLAN Show location and distances from ' property line and between buildings c) tom' r\C • 4, 1 , .1-' 1'4 \‘. .S, CC. • O ' lS O 4l Co