HomeMy WebLinkAbout249 22ND ST - Building Permits a
CITY OF COSTA MESA
(,0`01/A'F4q BUILDING DIVISION
FI I a 77 FAIR DRIVE,COSTA MESA,CA 92626!• (714)4'54-5273 • Fax(714)754-4856 • www.costamesaca,ov
FOR INSPECTIONS CALL: (714)754-5626
A""°^:`°" PERMIT NUMBER: M12-00025
PERMIT TYPE MECH STATUS: ISSUED •
APN: 42614412 DATE ISSUED: 02/14/2012
ISSUED BY: KJB
•
JOB ADDRESS: 249 22ND ST CM Suite/Unit:
Vicinity:
SQ. FT: 0 •
SCOPE OF WORK: CHANGE OUT FAU IN.ATTIC. 80K BTU. LIKE FOR LIKE
OWNER: MC NAMEE, DARREN SCOTT Address: 249 E 22ND ST Unit:
PHONE: 949-984-5511 City/State/Zip: COSTA MESA,CA
APPLICANT: ENRIGHT,PATRICK Address: 6250 PARAMOUNT BLVD Unit:
PHONE: 562-984-5511 City/State/zZip: LONG BEACH,CA
CONTRACTOR: RELIABLE ENERGY MANAGEMENT License No. 704414
Address: 7201 ROSECRANS AVEUnit: PHONE: 562-984-5511
City/State: PARAMOUNT,CA' ZipCode: 90723 . • CELL:
AF
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $52.00
PLAN CHECK FEE: $0.00
INVESTIGATION FEE: .. $0.00
REINSPECTION FEE: $0.00
TOTAL FEES: $52.00
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-NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
• it gulations.(Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
'INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
/required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
'CODE INSPECTION TYPE DATE INTITIALS CODER INSPECTION TYPE RATE I 1 N TIAL
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical
nF
.201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
At:
204 Final Demolition 250 Final Building/Occupancy
110
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license.
�. ❑Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance, as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
section 3700 of the Labor Code,for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number ase,:._ person person is required to descend,will be made in connection with work authorized
f
Carrier: 1 oi Lr St(GC 4- by this permit,and that no building structure,scaffolding,falsework,or demolition
(nos secton need not be cwnpkredatne pemms valued at one nurdre0 dopers(SI00)wMss.) or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
2.Art 2,Sec.341,Title 8,CaliforniaalAdministrative Code).
Policy Number: Valls.
0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above, unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should•
become subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
the Lab ori I shall fort Th comply with these provisions.
ZAf �2 Division of Industrial Safety Permit Number:
Applicant's Sigrutur a e ! HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force
eaand
,e�ff/ecc�t, a registration form for acutely hazardous materials? 0 Yes 0 No
Lic.# 70y'HC- Class it 13 C"36 CZO (Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
Z�y�2 each business which at any one time has on hand a quantity of acutely
Contractor's&valure ate hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lenders Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lenders Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits).
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK. and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
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 8. (If"yes attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code:The contractors License Law does not apply to an owner of signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
n ur of l al er(s) Date
Signature Date 2-74 02—
3057-46131071 444/ ,
And/or Authorized Applicant Dat
SitnpliiieiI l'rnncriptilir Ccs'Cil'icn to of complistn tie: 211118 Resit/ern tial fll`,I C'AItt:rztiuu.v 05e-l1.-.1l-A11.1--11 VA C.'
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Address: n _/ /•/ Loorcemw Age:
ter Ageer Lal:: Permitip
2.41_ 2L' llS. J I[T/ I1 �
• 1 • conditioned •Duct msutatiuiy,
Eoniameni 1,pe' List Minimum Efhctenev' .l Pinot circa mnuimmen( ti l Tlremmsnai
Packaged Unit QQ a. Over d(1 ftgf duc{.c�1
0/Packaged
0 AFUESO� 0 COI' ! „da: 0 Setbnel: '
Served by system added I replo¢ m
❑indoor Coil ❑SEEI< 0 F1SPF 1 /•' 1
(.1 ll atrearly present.3,111x1 In •
❑Cnndensin Unit 0 au ❑ltesicunlce• - al me nditio Ierl-k ace• nwtaflem
' L . 1.. f?.b (CZ 1.:i-5) - . ..
0 Other •
1.Equipment Type:Choose the coo pmenl being,installed; if 6161eJhnu unex\'stcnt, use another CF:Ili-AUf,If VAC for cacb.sysnenr. ..
2. Minimum Equipment T.fhlciuuciee:.l3SEEli,7876 ARE, 7.7I1SPF fiar.typicnl residential system::, ..• ..
Contrnetor(llticumi:ntntigti:Author's/Jtesponsibk Designer'Si/et:1m'akin Stntement) • ...
I ceniiy that this Certificate of compliance documentatiomis accurate and complete. • • •
• I am eligible under pivi slot):1-of the California business and Professions Code to accept responsibility for the design identified-on this
• Certificate of Compliance. .,, ..
• I certify that the cnerg femora and perfprmanre specifications fur Ibc design identified on Ilri:CCertifrcate of Compliance coufonn'lq-Ihe
• - -requirements of Title 21,1'urul.l and 5 of the California Codc of lCegulaumnt, • ' . . , ., _ . .
. The design features identilied.on this Certificate of Compliance are consistent with the information_documented on olhet.applicable. .. - --- ', .-—
compliance form:.,worlslieCIL calculation:,,plans and specificatipns submitted'tglhe enforcement sigeney for with.tne.permit. ._.. . - -.
1Jane: ... . . . .. . . . :. ,Sigmnture: ... . . _. .. _.
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.. - .Cirv(Statelip:a pG3YflW1Qllh� CA' .90713.` .. .. - - . . I phone:562 -911-7'551/
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2001 )(evidential Cmnplinncc Farina hi.,r„h 'm i n
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CAN'CUSTOMIZE 6VL7YU LE:T.7EREEA1J/SLr1L)
2011P, Building Energy Ei:•'fit:iene ' Standardti eteiidential iiTV/A C: A.ltetratioux
Climate! Zones 1 and 3 through 7 C %•- [t - ;:.ostia • ;c 29
RUN7NES6 ANI) PROFESSIONS CODE. SECTION 7110
Willful or deliberate disregard incl violation of the building haws, including the California Building Code,and
local permit requirements canstinnea a cause. for disciplinary action from the.Contractors Stair.L,icenxr.Board
worldng in canputetpn with the. Inca) building department. This action may consist of fines up to 3:5 010 per
violation or suspensaonirevnemwn of 1% contractor's license.
WHEN IS A PERMI.1'REOUE1'E)Y?
A written construction perms shall he obtained from the enforcement agency prior to the erection,conan'uclion,
reconstruction, installation,relocation, or alteration(Si any mechanical system,except as permitted-in Appendix
Chapter I, Section 112.2 of the.2007 California Mechanical Code. I rojeels requiring permits include,but are not
limited to:
• New EF'AC installation
•
?IV AO Changenul
• Replacement of furnace, coil, FA.U, or condenser
Relocation of an existing ElVAC unit
Adding or replacing more tltani40fi ducting'io unconditioned space
2111)8 PLRLI)RNG ENERG)`EFFICIENCY STANDARDS (Title 24;Port 6)RECIt TI Elk NTS INCLUDE:
I. Heating•equipment must have a minimum 78%AFUE(Exception: Wall-&floor furnaces; room heaters).
2. Central ait.conditiouers Es heat pumps.less than6S,000 Btu/hr must have a minimum l 3 SEER. •
3. Newly installed or replaced ducts must have a minimum insulation value of P_4,2, •
4. A setback type thermostat(24 hr clock with four set points) is required kit all alterations.
5. New or replacement ducts must meet the mandatory requirements of Suction 1.50(m l:
All joints and openings in the in the EiVAUsystem must be scaled.
Only nil 81,UL 181A,or UL 181B approved tapes or mastic shall be used to seal duct openings.
Connections of metals ducts and the inner core of flee, ducts shall h;:mechanically fastened. Flex ducts
must be connected using a metal sleeve/coupling.
Flex duet;that arc suspended must be supported every 4ft. max for horizontal runs with no more than 2'•
of sag between supports and 6 ft. max for vertical runs.
6. The CF-1514-WIECEL04 must he completed and signed by the installing contractor. The Inspector will collect
this form and verify that the model numbers are the same as the installed equipment.
1y J r .
CITY OF COSTA MESA
•
y' ,t) BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT P98-00427
t• O PERMIT PERMIT NUMBER
,*
(714)754-5273 • Fax(714)754-4856 PLUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 249 22ND ST Status: ISSUED f.W
Suite No Applied: 06/02/1998
Issued: 06/03/1998
Vicinity:
Parcel Nunmber: 42614412
Applicant: NOCK, RON
Address:
Phone:
Zip:
Owner MC NAMEE, DARREN SCOTT
Address 249 E 22ND ST
Phone:
COSTA MESA,CA Zip: 92627
Contractor. NOCK PLUMBING
Address: 11612 KNOTT ST
Phone: 714 8951246
GARDEN GROVE,CA Zip: 92841
License:707775
Arch IEng:
Address:
Phone:
Zip:
License:
•
SCOPE OF PERMIT
R/R EXISTING DISHWASHER.
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 '
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 '0 Wash Basin $0.00 0
Dishwasher $8.75 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $30.75
COMMENTS/SPECIAL CONDITIONS
•
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
fora period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS
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 carrier and policy number are:
Cartier: I&—hd F(\ jet- PolicyNumber: 701777
(This section nee not be completedt the permit is valued of one hundred dollars($100)or less.)
❑ I certify that in the performance of the work for ch this permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,end agree that I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these prov ns. �+Q
Applicant Signature: �Y Date: 49 - 3- ! 6
�C WARNING:FAILURE TO SECURE WORKER COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT Ml EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST.AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Buslnn,ss gndprofessions Code,and my license is in full
force and effect.Lic.q 7077'7 S' Class a
�{e S CCoo
I Contractor's Signature: i•--.!K^7l/lAl'P U _ Date: L" 3- ?6
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: Lenders 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,end the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to en 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. ❑Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ 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 Califomia 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 implication aEEermlt for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cale).
7 If aermit 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 end 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.
Si at Legal Owner(s) Date
And/)aLAutnSnzed Applicant Date
COOE_L IN5PECBQQNTYPE PAH INlMS CODES INSPECTION TYPE DAM ItUIDAIS"
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 2013 Final Plumbing /o as•qg r i
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Flre Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Buildlrig/Occupancy
2446.48
/b
\ 3 FROST 9a 22nd Streetre/tld BUEncl. PERMIT
JOB ADDRESS 249 22nd BUILDING PERMIT NO. 42262
GENERAL CONTRACTOR DESCRIPTION of WORK J�1 O0
�AP No. 118-114-16 LOT TRACT FIRE ZONE VALUE $
-bPECTIONS Signature Date TYPE V GROUP -r ZONE R-1
SUBCONTRACTOR PERMITS ISSUED
GAS Dote Number I Signature
WATER Plumbing •
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND H POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS 0 STEEL REINF. ❑
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE ri
SHEATHING
FRAME AND FLASHING
S�HING ^
LATHING — IN I OUT I I
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
H NG, VENT., REFRIG. AND A.C., FINAL
PL dING, FINAL AND GAS TEST n
ELECTRIC, FINAL .s
BUILDING, FINAL /`L- 9-L l(,
SPECIAL REOIIIREMENTS
42262 P ,,
iUl_ -9-76c1,00 973icv*� x:1^.5C' COSTA
MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLI A IO FOR STRUCTURAL PERMIT
For Applicant
`ttoQFill in Completely —(Use Ink Only RECEI E DAT RECE ED
BUILDING 4 ADDRESS a- T / rj(7n,o dl� 4 /� �
n /�/t^�r / p�( j, A.P. NO.I f a ' / P RMI. NO.
OWNER g�J/Q�//j) 0.1 &QAPNe �J//F 7 '�� IA
AMAIL
DDRESS S#9 al e ADDR E S,BUILDING 2491Ac2nD SI /' �7,
n //�oTELL �r� i •///.
CITY / .�s-b9 /beg NO.4y%-/3 ,rQe # �ckts' LOT/ 3 BLOCK
CONSTRUCTION NEW ADD^ / ALTER REPAIR MOVINGV_ DEMOLISH
LENDER -X
BRANCH T
OWNER/8/4/41/2Z) a,Ae ,v Raft
ADDRESS ``/ VALUE 11 lej Ci
ARCHITECT TEL. USLENL1 $ `
OR ENGINEER NO J
FIRE IJJ
ADDRESS ZONE LigiVPE GROUP
APPROVED -7V
CONTRACTOR BY DATE 7—?
l/
ADDRESSTEL. 2 E NO.OF USE OF76/ /�J I
CITY NO. �� 1 (PLANS L BUILDIN mabsebiriv
F-. STATE - CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
Lt] SIZE qq NO.OF SLOGS. (FROM /L� STR STREET/
p. OF LOT 5'p/ x /37.Si NOW ON LOT / FRONT tlFT. FT.
Q USE OF �f (.�.
al EXISTING BLOC. R.SIDE`t ` FL FT,
2 Separate permits are required for L.SIDE I`/
FT. FT.
electric,plumbing and heating work. -
WREARal FT. FT. {{/
USE OF BUII-DING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& `-
J I I MAIN BLDGS. ACCESS BLOCS.
jo /�X f. 33(, C URP. DATE
APPROVED
Q
), 5/vat /J L. ,' X p x-46 R1( b`lQ\ ` - DATE 0\ ' M)
CY
W
0 I hereby acknowledge that I have read this application and state n
N
Cd that the above Information Is correct and agree to comply with
m
L all laws regulating building construction, and I shall not employ
Z any person In violation of the workman's compensation laws of o
=Isi the State of California. m
I hereby certify that I am properly licensed as a contractor under SD. FT. a
the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses era in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT EE ON e
am exempt from the provisions of the State of California Business VALUATION
and Professlo Code, Division 3,Chapter 9. + PERMIT FEE E a N
Signature f /] / / //J`��7� A/ /t PLAN CHECK E , O
is
Permittee �r�.�/m/ i' $ /�/O TAX Si s a U
Authorized Agent TOTAL PAID E
/8` 5
OWNER C. M. Sutterfield DATE 8/24/59 _
JOB ADDRESS 249 E. 22nd St. BUILDING PERMIT NO. 10240 _
GENERAL CONTRACTOR Owner VALUE S 6000
AP. No. ]]8_3i0_81 LOT TRACT FIRE ZONE DESCRIPTION OF WORK ,eloc. 'ove- dwel
1PECTIONS c .-.- . Q DATE S
J ? (I I GROUP I & J TYPE V ZONE
.dergrouncl Soil 4,1.77U.G. WaterivY} -7-tic^60 SUBCONTRACTOR PERMITS ISSUED
Underground Gas DATE NUMBER
Overhead Water and Gas
Rough Heating /1/� 9-36-,5 Ill fW ' 9-/4--, 9 a a S'7V
Rough Plumbing ( Y meq, ,, a - 9_ y 4
Miscellaneous S y / 87 ,
Prop. Swr. feint- Ilous'*Con. Stt r• q/14/'.-g tee. S. efi lf11-j 7-40 YX
Sprinkling System
Heating, Final �Ay.• f _9o \ -,l "1
Plumbing Fixtures / �j J _.<
Final Gas Test/5 44/5 9-540-591 u
Construction Pole / , '/''
Underground Power l 1
Rough Wiring #%t. /ii14B�/ Z( „",I? . 2a4 . /e -/?-,!9 /a,T/ / b)4}.i
Trenches �j'd ¢/- Forms Steel b'1,7-ri " it,. '""°"--`" t,.cc e, /• -'v-• r /.s ....• p,q,a aV $
Floor System /j.(gt4�f)-4.:Hrn4,1,96n/�_ Q'IL-51_ _ __ ���/// a.
Steel Reinforce Chimney Rejtod /yy/ " ,1pJ ^Itlf,
Bond Beam ' - 9 '/,
Shing e-y�;! IlAVJ�' w
I ;;i=;c and Flashing . `'!„-�
Llitiing, in Out /' d
Plaster, brown coat
Plumbing Fixtures, Final MI-)1'-;3o -,+g fr
Electric Fixtures, Final 12,(c et,LQ r54'
Building, Final //'y> 41/9,
OCCUPANCY I
Form 210-3M-4-59 n •r
r.� �,� '.. �• 10240
...-- - 10240 81 a s---ifu u
hd
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 317 COSTA MESA. CALIFORNIA r111T'1 MESA IPI OF. 1 A MESA
FOR APPLICANT TO TILL IN COMPLETELY APPLICATION FOR PERMIT
I
(� TYPEOR PRINT
BUILDING
ADD EISS(J149 GYP � �'1 ,
COSTA +MESA, CALIFORNIA FOR OFFICE USE ONLY
/1 RECEIPT NO. PERLeee 7MI�IT�)No.
OWN
MAILER ,•
/' �I�� RECEIVED BY I D TE RE�CEEIVED'q/l. DATCYSSUED
ADDRESS 3 Fg• g .-19 ti _iN ! I C! � .-/ v— Z/57
CITY Off. ! n ' TEL. BUILDING
.F„N ` NO. ADDRESS
ARCHITECT LIC. COSTA MESA. CALIFORNIA
OR FAIGINEER NO. II
ADL. .35 FIRE
ZONE TYPE GROUP-1
y STATE APPROVED �}1 /
CONTRACTOR yw� LIC.NO. BY
Tit DATE /�/ADDRESS / NING L-,y,vi
LEGAL LOT ^�( /� ��� /.�/ ONE 1/ NO.OF USE OF NEW'I
DESCRIPTION I NO. _{�(/ ' BLOCK /, ACT JJ� Y PLyAN/$ /�I BUILDING T-.� " �'�e _ �-
A.P.NO. r )£�/Q 7„"!-�/ / 0 -- 9a / APAPPR��VOVIIIED&�/�' I L/ /,TOR r1SIZE
�OF LOT, J D 1 p / . / I NOW ON LOT NO.OF -�' YARDS /V/ !/ LO
REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT J UFT. IN.
SETBACK LINE FROM (� 79 R.
CENTER OF STREET ,_J 0 REAR YARD// R.SIDE / / FT. _ __ IN.
SIDE YARD I LEFT 7 I RIGHT /4 L.SIDE 7FT. IN.
DESCRIPTION OF WORK 3
REAR S-FT. ^ • IN.
NEW I II ALTERATION I II ADDITION I
REP..... I II MOVING I II DEMOLISH
r„,. ,
. 3 s / 13, I
SUILDING5 0, OON I s !/r
SIZE OO MS //��STORIE�S�
EXTERIOR IN WALL ROI COVERINGVF
//lJyvV/.I-� L . f g (`f'
COVERING /
USE OF BUILDING AND WORK TO BE PERFORMED
124AstizIL.1, 74—
J
I H BY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. ,/ VALUATION
SIGNATURE OF a-1i+n A ,// PERMIT FEE $ /� ��
PERMITTEE // �/ )) A !.'C r 6 '
$ PLAN CHECK $
AUTHORIZED AGENT \ TOTAL FEE $ el, 8--O
>' OWNER SUTl'ERFTF.r,n, CHARLES DATE SEP 1 7 1963
JOB ADDRESS 249 E. 22nd St. BUILDING PERMIT NO. 20583
,3GENERAL CONTRACTOR' Same VALUE $ 4,800.00
X AP No. 118-114-16 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Den&Bath Add.to
PECTIONS Signature DATE GROUP I TYPE V ZONE R1 Res.
bull 47 /O-/-Lj SUBCONTRACTOR PERMITS ISSUED
Gas DATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. [1
Rough Heating /�,/���/S24-2- ----j
' ( (ti, ,.,.,:,✓ 1!4/-e 9 ./_} a2 & /2
Rough Plumbing �� - 0(_ /- -6"; .cr-cvr�/ d .Iy r7-/7 -L3 39; 7.� -
Prop. Swr.oL5 0i .,G (fI-GV-v�y✓ r'� //-iy-G°i 3���'� �
Prrin Line House❑ Con..p . Swr. ❑ ,e,A/'
Sprinkling System /
Construction Pole / (9
Underground 0 Power p B or-e.eA--a.cz.c. /,--.07745 07 4‘7,7/-
Rough
�7/ -
Rough Wiring Ca 7/Z9: �+�•-� %-/7-c3 j'�ir_
Trenches A Forms:0 Steel Reinf. 1pc fie.* JIi 3 • A3
Floor System
Bond Beam 0 Steel Reinforce 0
Shea thing R rye I I-7- 6er
Frame and FlashingL o- / 2 -' _34_34Lathing - In , - Out / %a c /4,- - c /7Q 1
P er, brown coat IR /-g- 6Y
FEl . p Air Con. 0 Final
Heating, Final a 3-/, -L'/
Plumbing Fixtures, Final 7%c j. -
Final Gas Test /y -` /- /- !''
Electric Fixtures, Final 1 !. j.(,.4�'
Building, Final Q- - -(�d
OCCUPANCY I ,
Form BU4-8M-3-63-5-B P oncMu
a
2u583 FEE RECEIVED
oySEP 1 7 1963
'COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 317 COSTA MESA.CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING a ,1 n (i e a, .�/� .
ADDRESS Y 7 {�'
RECEIPT NO. PERMIT NO.
COSTA MESA, CALIFORNIA 1 _� 5 7 3
0,�_ ,11 ��-���+//J-J' RECa1VHDHYXf/ OATj ICH! D A 7S 203_
OWNER '^^'_ -/tYV./C Ca'E✓( DIN /N(� LJ n/ c i 1 J�
MAIL ? /y CJI ADORE88 . ` L. 2 i '/
ADDRESS J�� �� i
FIRE
TEL.CITY �ag' �Yr-,.tu` NO. ZONE TYPE GROUP
APPROVED
Vey/r /
ARCHITECT TEL. BY 1/ //l' DATE �l-7"-//N
OR ENGINEER NO.
Z NING
A. .ESS .T� �/,
t „../e�� E NO.OF USE OF NEWf/�YI
��I PLANA a BUILDING CONTRACTORq[ I' h
ADDR E883 O u /� � LEGAL �Y L07' 2 £J3 � -�rl. ?j�
/�_ �� /� DaacRlPnottii j �}
CITY e( vi(i"c'IL / 4-/� P A.P.NO. I / b - 114- lb
STATNO./ 57 Cr TEL.
NO. NOTE:0” O DAVE OVERHANG I-, SHALL BE LESS THAN
3 90'TO SIDE Et REAR P.L,
EAVES
SIZE L- v�'l/ /b 7 I NO.OF NOW ON LOTH ALLOWED (U. B.C.REQUIREMENT)
OF LOT O (1 ��7� C�.��G//��'� YARDS APPROVED YARDS APPROVED
USEOFC 4 MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. (FROM C/..e7RREST)) -{ {/1 c
SETBACK LINE FROM C 0 REAR YARD A FRONT n//CFG:A7 •o —/I" 'J�/FT.
CENTER OF STREET /
SIDE YARD I LEFT 7 I RIGHT / R.SIDE /�FTt FT.
DESCRIPTION OF WORK L.SIDE 7 FT. Fr.
REAR 33 FT f' "/2CAI FT
ALTERATION — ADDITION /�
•
1 DISTANCE BET. BET. MAIN @ 33 ,
REr AIR MOVING DEMOLISH MAIN BLOCS. ACCESS.SLOGS.
BUILDING NO.OF VAR. DATE
SIZE ROOMS STORIES C.U.P.# APPROVED A
EXTERIOR WALL I ROOF COVERING BYPROVHD /If49 DATE ?////a5
COVERING �/
USE OF BUILDING AND WORj(TA% FORMED
L]Y"n ✓\ l"' IJ 0 et6Q.FT. G
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 9
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATINGVALU ION fr°
BUILDING CONSTRUCTION. C. 17
SIGNATURE OF/�7Z PERMIT FEE $��I n
PERMITTEP l n /-✓
$[/X co, PLAN CHECK S / O
AUTHORIZED AGENT �7 VVV �^/ ^ �(} E
TOTAL FEE $'^ %' '