Loading...
HomeMy WebLinkAbout279 22ND ST - Building Permits w9 CITY OF COSTA MESA - BUILDING DIVISION >• DEVELOPMENT SERVICES DEPARTMENT_ PERMIT NUMBER 1. 1 PERMIT o I k B05-02215 Sbeft.nno (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.&LNLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 279 22ND ST Status: ISSUED Suite: Applied: 12/05/2005 Vicinity: ROOF Issued: 12/05/2005 Primary Occ: R e of st on: Parcel Number: 42615307 Zoning: Applicant:ddressWPO BO EY ROOFING AV -- NEWPORT PO BOX 15396 Phone: 949-548-0769 ISSUED BY: NEWPORT BEACH,CA Zip: 92659 Owner: BOREN, HILDA E Address 279 E 22ND ST - Phone: COSTA MESA,CA Zip: 92627 Contractor: WHITNEY ROOFING ` `t" Address: PO BOX 15396 Phone: 949-548-0769 • NEWPORT BEACH,CA Zip: 92659. License: 406022 Arch : Eng: Address: Address: Phone: Phone: Zip: - License: - - License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF.INSTALL 1 LAYER OF 15#FELT,30 YEAR COMPOSITION SHINGLES:AND REPAIR/REPLACE'SHEETING AS NEEDED,24 SQUARES. • FEE SUMMARY :Plan Check : $0.00 Calc Valuation: ,57,232.00 Permit: $153.25 : Claim Valuation: $7,232.00 SMIPRes: • $0.72 SMIP Corn: . $0.00 Other ,$0.00 Inspection: $0.00 Total: $153.97 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 r"' • Right 0-0 PARKING --Existinq: -0 Required: 0 Proposed: -0 • 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(WOO) 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 ptovlded 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,: +•uired 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 numb: :re: C ca der. A . .:; S 2–%J C P.r1tiglNuihber. 2 0 (This sec on need not be completed if the pe - C'ed et one unfired dollars(5100)or less.) o I certify that in the performanc: • e wo• or whi h this.emit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C:' •mia,and '•r:- . I sho d become subject to the workers'compensation provisions of Section 3700 of tha,Labor Cgde,I shall forthwith comply with these pr••sions. n/ � / Appp6can 31gnaNre: / • "new. -• 'Date: /` �J D.S WARNING:FAILURE TO SECURE WORK'• 'COMPENSATION COVERA IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(S100.000).IN AD.TION TO THE COST OF COMPEN'•TION,DAMAGES AS PROVIDED FORIN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I unlicensed under pr•visl•z hapter 9( ..mmencing with Section 7000)of Division 3 of the Business and Professio C e.an y li nse Is in full a n effect:Lic-p s'R'� � CONSTRUCTION LENDING AGENC . ❑ 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑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,end that no building structure,scaffolding,faisework,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 Califomia 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 ❑No (Section 25533 of the Califomia 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 end 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 Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of en RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No 5._..........D_...._._ Does or will the applicantsAiror Quality a or future building occupant at y ohier for the work which is the subjectage of this implication e0P No for such construction or modification from the South Coast Air Ouallty Management District or from any other air pollution control district or agency? Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any part 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 Califomia 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 prescnbed by Califomia Health end Safety Code Section 42303 been made? 0 Yes 0 No 8 (It yes",attach certificate of compliance from the appropriate air p.Ilution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of •erjury the information given above is correct.I agree to comply with at state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: i CERTIFICATE OF COMPLIANCE AND AUTHO:• • r•N OF E • :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 I. en• ty ordinanc:- relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspecti••• •u ••.:5,I agree no •occupy or allow occupancy of any building authorized by this permit�un^til final inspection. ignayrs) of .9 - • d/O Authoazed,Applican Date:—^^y CODE tINSPECTION TYPE — PAIS I71IML5 CODE INSPECTION TYPE PA_Ta !MAI& 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root d 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 CITY Or 1STA MESA PA lot FEES N4 16 6 --7 Fee Payment Receipt r�-- Project Address � / y 2 / Park Area A. P. No. 1113 --/t-2— o9 Building Permit No. 11/11�0 Owner's Name Pie/lard b. Bore Mailing Address.02 7 Va Camc=//ttk._ I FEE nn Single Family * No. of Units / @ $455.20 = ' P a Multiple Family ** No. of Units @ $321.32 = �7 Total Fee Q 4/3- 5 ' • L6 • Planning Department Approval Date -70 0O By l A �� Applicant's Signature �f/ :2/1sSLawC_ * City Ordinance 72-44 ** City Ordinance 72-45 *** City Resolution 74-124 C,U1 1 '� White-Planning;Canary-Planning;Pink-Finance;Goldenrod-Applicant CMF 0174-26 AA JUJ RORFR , Richard D 4-8-76 JOB ADDRESS 779 Fact 72nd StrPPt BUILDING PERMIT NO. G1428 GENERAL CONTRACTOR rkranrpudr DESCRIPTION of WORKRes. watt. gar. 4AP No.118-152-09 LOT TRACT FIRE ZONE VALUE'S 48,000.00 li .CTIONSGAS Si nature Dote TYPE V GROUP - & T ZONE R-1 •J �y��•){. PEf2MITS ISSijED ROU SUBCONTRACTOR I I WATER Date Number Signature t,„ (2•a 5. -]6 Plumbing ROUGH PLUMBING �].�J 1S-4-2(� //(,�yyQjL l am• lit D 7c 18835-7— PROP. SWR. LINE ❑ HOUSE CON. v(jr„r�y• /Y{, D U-'Il. . i-n 76 69b&<— SPRINKLING SYSTEM ♦ MISCELLANEOUS „� . fiyt.--0...9// J -60ROUGH HEATING AND AIR CONDITIONING IZ-,Q 3l- . TEMPORARY SERVICE OR POLE r' v cif. S( UNDERGROUND 0 POWER {R(.i �' /w�yyyy ROUGH WIRING R\C- d-1I'¢ Heating and Vent. TRENCHES 0 FORMS 0 STEEL REIHF. 0 414 FLOOR SYSTEM M(QQ' /c ' c1;229:7b lZpl/ BOND BEAM n STEEL REINFORCE n SHEATHING Me. t-L3•4 FRAME AND FLASHIN i 1- LATHING - IN Id., OUT 771140941tS- PLASTER. BROWN COAT RC- .ea0-74. ST^"'ITURAL, FINAL � Electric H G, VENT., REFRIG. AND A.C., FINAL ,(12.0 11,0/-)6 i,aw>Y— /c .. . • $'-/3_74 903 99 PLUMBING, FINAL AND GAS TEST [Z P.c n.--13-16 0knam.is'OP- • 7-Q1-74 Un�J8'� ELECTRIC. FINAL .'._^ /A. a 0•6,ntt.art i Or 7•G• 7G 40137 BUILDING, FINAL b. 0WIti L• / ' i� a-ill-yG in G75 / G —A 'IAR 16-76-M LO0 78313****93.S6 4' 4 1428 ia4.) r-,FPAILno ?sr . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely - Use Ink Only gECEI DATE RECEIVED BUILDING /]/� /J �•E�i � 3/G 7G � . �.� ADDRESS 07 ° .EtLY7C- p -/6 (] �s/� OWNER /(/G�fCG � O ....aid A.P.NO. I I O� J`7�Ge O-I ETIrog MAIL ,c/ /.7 ADDRESS 77 A DDR ESS0 _72- .0.-- (_..`:07 c/�* 10/r.TE .// ADD E � CITY /JeT/rt /7c f! NOL 6f-z-y RP` T T 1 gr BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOI ISH LENDER BRANCH X ♦��• ADDRESS - OWNER /-w'C O �/p-��y��y GA/',�rj(N[J ARCHITECT TEL. USE N�7L� `�S�QGr—►" /(/4�a � VADDOR ENGINEER NO / i_47- APPROVED FIRE WPE RESS ��qsQ� ZONE / GROUP CONTRACTOR o ��6%✓-/✓44-: BYPROVED DATE ‘#',((J ADDRESS TEL. ZOO NO.OF2 USE OF NEW CITY NO. /` r PLANS tT BUILDINGCCO iy�r I^ STATE CITY YARDS APPROVED YARDS APPROVED (/'�/ LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING IQ SIZE / / r NO.OF BLDGS. (FROM C!/Yt,�ST E�����srGGyy /J /� 7� B. OF LOT (n f t 91 1G /IS( /S NOW ON LOT FRONT `Cc rT.!—' OGQ( c�U. " yUSE OF I. / // /t EXISTING BLDG. _B.SORE." el FT. to c-/ / ✓ ESeparate permits are required for L.SI/Ed r-423-61, 7-:— FT. C electric,plumbing and heating work. REAR "T�i. 13 / trFT. 7----\[w.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& `- ' '2 MAIN BLDGS. ACCESS. BLOCS. CI VAR.# DATE 4t /'� �_-_- t - - -L C.U.P.# � ) APPROVED)' �J/' } X/. �,�y�/ / r„gr• APPROVE 1. r. r° 1 �y'6 a�4 4I—F-7,C .-1 / ' CAD F i(LCSF'ELIALII# . UIREMENTS w i �C -- p I hereby acknowledge that I have read this application and state n Sthat the above Information is correct and agree to comply with m all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of /n4 m m SW the State of California. endi—I hereby certify that I am properly licensed as a contractor under SO. FT, 66;9 ev Si1 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR .]m.C. Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: u am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ O and Professions Code,Division 3.Chapter 9. _ JI cn�� � o Signature of ! PLAN CHECK $ 50 G c.` Sermittee �'�-�- $ Gl-Q QD TAX $ LL3 ,3U Authorized Agent U /U TOTAL $ /3 (2\ , I I -A r 4i 421JSPR —8-/6 ,",tu00 462 i;*** 131 00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only gECEI DATE RECEIVED BUILDING /I /����� D EIS$�U � ADDRESS fesC ` ate—A.) ��� �((J� ��Q�^ L/ ^A PERMIT NO. OWNER /�L., ��IS�s/t A.P. NO. MAIL BUILDINGDRS � 77 /J�J�d Cr ADDRESS ADDRESS�[ / GTI/ TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION N W ADD ALTER REPAIR MOVING DEMOLISH LENDER n /+r[/,, BRANCH OWNER 4c 9g,g c&veEA / ADDRESS PeC VALUEE ARCHITECT TEL. USE OR ENGINEER NO. FIRET ADDRESS ZONE TYPE GROUP :.L� APPROVED CONTRACTOR BY DATE ADDRESS • TEL. ZONE NO.OF USE OF NEW CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED . LIC.NO. LIC,NO. MAIN BUILDING ACCESSORY BUILDING W SIZE I NO.OF BLDGS. (FROM C/L STREET/ G OF LOT NOW ON LOT FRONT FT. FT. ne USE OF V) EXISTING BLDG. R SLDE FT. FT, Eh . FSeparate permits are required for L.SIDE FT. FT. Ci electric,plumbing and heating work. --) REAR FT. FT, I—I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& xt MAIN BLDGS. ACCESS. BLDGS. 01 VAR.# DATE "'j C.U.P.# APPROVED d > APPROVED BY DATE R' 0 I hereby acknowledge that I have read this application and state n CC that the above information is correct and agree to comply with m 6.i all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of (4 the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. CJ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY' am exempt from the provisions of the State of California Business /} OOP lir VALUATION _ PERMIT FEE $ /x��� p and Professions Code, Division 3,Chapter 9. `/ N v' m Signature of PLAN CHECK $ �' eno 0 Permittee TAX $ �� LL 2 // U Authorized Agent TOTAL PAID $ ..m. �JJ UWNLR gOREN, Richard DATE 2-23-76 JOB ADDRESS 279 East 22nd Street BUILDING PERMIT NO. 41329 GENERAL CONTRACTOR Owner/BI dr_. DESCRIPTION of WORK Demo. House AP No.1 18-152-09 LOT TRACT FIRE ZONE VALUE $ I .000.00 11 it CTIONS Signature Date TYPE V GROUP ZONE R—I 'sal, SUBCONTRACTOR PERMITS ISSUED Q GAS Date I Number I Signature WATER Plumbing ROUGH PLUMBING leuw2/QttGL. a-a3-?6 6CS4G.---- PROP. SWR. LINE 0 HOUSE CON. n SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING • TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES d FORMS C] STEEL REINF. 0 FLOOR SYSTEM BONO SEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING • LATHING - IN n OUT n PLASTER, BROWN COAT ST-TURAL, FINAL Electric NI G. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL .y BUILDING, FINAL Art-_5 5—ne� `e I/ • 41329 FEB 23-76rM00 874 ****10.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 P IC ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only - / >7 q VE Y DATE RECEIVED ."- LgSI'= ECBUELDING IVED/ a7/ �.( aZ- '5/�I' Z3 OWNER �r-,�l>pe" '6 A. A.P. NO.V18—t �� I PERMIT NO. r BUILDING ,�MAIL �7Ei ADDRESS 07/ ,- Cyitnt e /' hrO - ADDRESS•, f eJp CITYe. TEL. N R•CT LOls{J� BLOCK Cosy4 /.97e ice-- NO. CONSTRUCTION NEW ADD ALTER REPAIR MOVING r1FMOI ISH LENDER 1-J BRANCH �. IOWNER iGts ,ep •©REai ADDRESS �t VALUE ARCHITECT TEL. USE USE $ I OR ENGINEER NO. exi ADDRESS ZONE TYPE.ilt— GROUP CONTRACTOR BVAPPROV `r DATAI2-3(76 ADDRESS TEL. ZOy{•a NO.OF^ USE ON WAOLO CITY NO. ( PLA BUILDING F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE / NO.OF BLDGS. (FROM C/L STREET) A+ OF LOT X.5-0'� I� I NOW ON LOT Y FRONT FT. FT. Q USE OF EXISTING BLDG. �t27,-, R.SIDE FT, FT. FSeparate permits are required for L.SIDE F . FT. electric,plumbing and heating work. 0 REAR FT. FT. [id USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN MAIN BLOCS. ACCESS.SLOD GS. ..1c...../z_ VAR.+ DATE Q X ,.&c t 8 -"AQ Et S u C.U.P.qY+ APPROVED 7 APPROVED/r t 4�a��,✓ DATE t l'3-7v CC Ial O. I hereby acknowledge that I have read this application and state n (:4 that the above information Is correct and agree to comply with m p' all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of it the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. n the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT EE ONLY: e am exempt from the provisions of the State of California Business e-L v VALUATION PERMIT FEE E and Professions Code, Division 3,Chapter 9. m m Signet of � 79 PLAN CHECK $ `. loin, 0 Permitta �• ^� S rV V r� TAX $ • U. U2 U Authorized Agent TOTAL PAID $ 10. Sb