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Home My WebLink About2225 WALLACE AVE - Building Permits CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT698-0088R u * PERMIT PERMIT NUMBER " o.mm (714)754-5273 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2225 WALLACE AV Status: ISSUED Suite: Applied: 05/21/1998 Vicinity: Issued: 05/22/1998 Parcel Nunmber: 42241206 Zoning: Applicant: MILLAN, ELIZABETH Address: 2225 WALLACE AVE Phone: COSTA MESA,CA Zip: . 92627 Owner: MILLAN, ELIZABETH • Address 2225 WALLACE AVE • Phone: - COSTA MESA,CA Zip: 92627 Contractor: Address: . Phone: • Zip: License:' Arch/Eng : ' Address: - Phone:... • .Zip: • Licenser SCOPE OF PERMIT CONSTRUCT 6'HIGH PLIASTERS WITH WROUGHT IRON ALONG THE FRONT,AND SIDES OF THE FRONT OF THE PROPERTY; 36'4 FRONT, 19'6"LEFT SIDE;26'4"RIGHT.SIDE. MUST BE ON P/L • • FEE SUMMARY . • Plan Check: $48.59 - Calc Valuation: $3,000.00 Permit: $74.75 Claimed Valuation: $3,o0o.00 Other: $0.00 • ' • Inspection: $0.00 - Total: $123.84 • • PLANNING &ZONING • SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 , Left ; 0-0 Right 0-0 • ACCESSORY Front 0-0 'Rear 0-0 ' Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: • • 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 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. El 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 canier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which 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,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($1W,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 Business and Processions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit ts 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.). ❑ lammp under sec �I r Business and Professions Code for this reason: V-Signature: / � 1 2m�� ititA k Expires: i L 4 Verification of Ownership by(type of document,i.e.-properly 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? ❑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? ❑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 tiling 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 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit 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 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agencIs required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property or inspecturposs s.I/ l agree� not to occupy or allow occupancy of any building authorized by this permit until final inspection. Lzp1 I(J fVlOf Legal Own(sr(s) Signature (` • And/Or Authorized Applicant Date CODE# INSPFCTION TYPE DATE ANIMALS CODE It INSPFCTION TYPE DATE IALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final • '• ' 208 Final Plumbing' • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall `_I7� 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 244646 �y00.ra9 2 s fee i 5 ,-ce • i —18-0dgs' gt - Y Ct a APPROVED =� i , I .e S (Fref- CITY OF COSTA MESA I _ _ PLANNING DIV. r- ,/! _. .. X Q. SUBJECT TO BLDG. DEPT. REG. 1 BY ( j v DATE S 2�4 v) in IVISicThi Of. B DLL DING W t w ?it- 4A aK i2 tZ,c 1Z CIT YOPCOSTA M SA SAFETY I G� ay le AI'PR0VRD 4 GF n t 1` +; 11:a 9� ` T,;s set of plans and specifications Date J 2 1 l e III ,� > G Iii 1-, - �� make eYchangesoralleratononsaMUSTboekeptonthisjobalalltmesan tis „� I Fn / ty,ClryofCoslaMesa nPe`nssionfromthepa"dulto r ren C0� the stamping his — O J l,' pion of Building n oft (( Un o'fhA, plan ivyi be held topemtorl be .�,., I ! ,. 11 �� -7� These 4icn and pBm�Ii snag p iS 0f my Oily of Costa b Asa Ordinance an approval "�"`�.,, 1i �O I. "Tierce r p; by i lil a!on and IFS is a State law ttntrA AS PI __ , l--- ii 7n Mg a <c wibin 30dif he i B l , '11 VI rC rYv,lini � , building or i�� C �� 9 60 asoiisauyioe �I v RESIDENCE RESIDENCE RESIDENCE RESIDENCE F. L. WW D J it I_ C _ ~ In ^ ,� C N '^ o- STREET TYPICAL 611 CONCRETE BLOCK FENCE • Cement Coping Optional Channel Block With 1.3/80 jt SI - - . a list GENERAL '+J _ CITY OF COSTA MESA ► :y ►, BUILDING DIVISION Fr .. e. .:4 i DEVELOPMENT SERVICES DEPARTMENT • PERMIT PERMIT NUMBER 4400starn ill B98-01657 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2225 WALLACE AV Status: ISSUED Suite: Applied: 09/16/1998 Vicinity: • Issued: 09/16/1998 • Parcel Nunmber: 42241206 Zoning: Applicant: RONNIE ALEXANDER Address: Phone: - ' Zip: Owner: MILLAN, ELIZABETH Address 2225 WALLACE AVE ' _ Phone: COSTA MESACA Zip: 92627 Contractor: RONNIE ALEXANDER FINEHOME WORKMANSHIP Address: 15068 rosecrans Phone: 714-522-3045 LA MIRADA,CA Zip:' 90638 License: 468300 Arch/Eng : - " ' Address: • Phone: _ Zip: License: SCOPE OF PERMIT • .T/OFF&REROOF 2200SF RESIDENCE W/BUILT-UP. • FEE SUMMARY •_. Plan Check: • $0.00 %. Calc Valuation: $2,800.00 Permit: ' $74.75 - - j' / Claim Valuation: $2,800.00 SMIP Res: $0.50 - / / SMIP Corn: $0.00 . Other: $0.00 -- Inspection: $0.00 Total: $75.25- PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 - Left ' 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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 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'comp ns tion I surance carrier and policy number are: / / '/b,fyp -10Carrier: <f Policy Number: s+� Zr (This section need not be completed he permit is valued at one hundred dollars($100)or less.) e ❑ I certify that in the performance of the work for which 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,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwitH h comply with these provislyns. ,., // �r Applicant Signature: [[ 44-7/ Date: / r/C- gr- • WARNING:FAILURE TO SECURE WORKERS'0010PE1CrION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN 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 ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Seen 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# 41 tT 5o,,: r Class# Q / 7 Contractors Signature: G.ys'. i-- / Date: S •/t '7r CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: ____ Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,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? ❑Yes ❑No (Section 25505 of the California Health end 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 tile a registration form for acutely hazardous materials? ❑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 Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes ❑No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) / 5'4Date M7— '—', r, And/Or Authorized Applicant ( Dale ...- CODEa INSPECTION TYPE DATE °MALS CODE I I6SPECI1ON TYPE DATE DOIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �/��/ 208 Final Plumbing 200 Final Re-Roof lai it 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 2446-46 PROJECT ADDRESS: 2225 WALLACE AV / 1R UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 066103 • OWNERS NAME: CROCKETT, RONALD C (p V ADDRESS: CROCKETT, MARIE L_ PERMIT NO: P 066103 PLAN CHECK NO; N GOVT: N SUPP : N 2232 WALLACE AVE COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH 646-0385 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : CHANGE OUT WATER HEATER SQ FT: CLAIM VALUE : CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: A—AMES PLUMBING & HEATING ( 714 ) 530-2440 ADDRESS: 10422 TRASK AVENUE COMMENTS : WATER CHANGE OUT ONLY GARDEN GROVE CA 92642 ***- *****v6-x**+e+C*****x-+raE9r*-x-+6-x--x-x--ee******** -N**+tx-*+6*96*** ->t**96It9t*9t* Pat-x***N-N-*96-er** -9c-9e* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU I R EMEN T S 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B A C K S CITY LI 066 ST ELIC.: 50307 _ CLASSYs. ; Date: Signature: " MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION 0 LARAT N: Ihereby affirm that I have a certifica Air to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy.thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: PC941094 , 93 EXP.DATE: 03/01 /94 COMPANY: REPUBL IC PARKING REQ: PROV; PARCEL: 42241206 ZNE : REF NO: 0 Certified copy is hereby furnished Certified copy i tiled with t ' i • Division. PLANNING NOTES> I EXEMPTION FROM WORKERS'COMPS ATION DECLARATION: (This section need not be completed if the permit is for one hundred(Stip)or less), DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which 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. ZONING APPROVED BY • • DATE: Date: Signature: NOTICE: If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY , DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY ; . ***.µ-.x.**• .#1ElEiEfEiEfffFi?lfiCti !E*1fi!•If it lE 1f 1E 3E>F iE3EDiEATiEEiE:E*iE ffStlELiL which this permit is issued(Section 3097.Civ.C). tf FiE iE LENDER: ******************************************************************************* ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: Ihereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 , 00 repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 2 5t SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(8500). ISSUE FEE 20,00 • I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 7 . 00 20 , 00 0 . 00 27 . 00 27 . 00 , 00 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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED; 27 . 00 OVER/SHORT; . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ' and who contracts for such projects with a contractor(s)(cense pursuant to the Contractors'State License Law).l am aware {(.**********.*.7E*{(.*.***.*.y.*.*.*.**y.*.)E*.x•.N.**..If*.N.**..rf..1(..1E***•7E.1f.1F.1(..N.****.If**.I6*.7E.lE*.)f*******,*.*.*,Ip*.*.*.N.* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN O I am exempt under Section: B.8 P.C. , ter thisreason' TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: OwnerPLU 1 ,WATER HEATER AND/OR VENT' 'rt 7 . 00 7 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 2 END OF ]FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. EXPIRED, Date: Applicant: ',n te In e c io I hereby certify that I have read this application and state that the above i ormation is correct.I agree to comply with all city and county _ _ ;� Ce i e s ordmancesantlstatelaws relating to buil& construction and hereo a rite representatives of this city to enter upon the above-mentioned e" --Vx —� tug property for inspection purpose � � 01 00155600-00155600 TOT 27.00 Date: Z-----/ Signature: OAiE 02/17/94 TINE: 11:23 Driver's License or Social Security a: fff-- _ 7,_,k-41 1641-46 White—Butidino;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;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 UF ER Grnd. 57. APPROVAL TO COVER-G UNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, D 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 ❑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. REQUIREMENTS -- - - 31. Plaster Brown Coat 79. FINAL INSPECTION -_ n 32. Electrical Power Meter-Fina! 80. FOOD CERTIFICATE ISSUED ^;:;, 33. Final Electric Notes: 34. Final Heating & Air Conditioning2'-Z --C' !- ccand-criat ay, 35. Final Gas Pipe-Test C7CL 36. Hood or Canopy g 27-Ct4 eee,a 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer c T� 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - ' No. Date OWNER KOLL CONSTRUCTION CO. . INC. DATE 3-6-57 . JOB ADDRESS 2225 Wallace Ave. BUILDING PERMIT NO. #4522 GENERAL CONTRACTOR Owner Bldr. VALUES 10,304.00 LOT 6 BLOCK TRACT 3065 Res.Watt. gar. GROUP I & J TYPE V ZONE FIRE DISTRICT 4474 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench /yam/ ;Mr Foundation Forms and Grade to Cara e Rough Framing > " 4 S/ - Plumbing,Rough to Slab S&L-a.*4.0,, y -71,7 , I_4), CO e 3 - 2 -S7 Po 4. Z Plumbing,Rough Complete ,�g f7 4 3 i i Temporary Pole v" `�� Wiring, Rough thi . ; • %i�/ ;•� ?�vn4:.i 3-o1S-Jr7 2/a,s�� Heating,Rough ,L a 1�/j [ � u�R M p�u,.a„ 3 -022-6-7 ea.// Heating, Final , , S S=9-SJ Id", flower, House`✓49;j 1Sewer,SLAMIS -6-S7 442_____42-4-4(a____ - - • 5 ,9 74 7 Septic Tank or Cesspool , �...l� Lathing, In Out r /,3 S-1- Plastering / Plastering -23- Plumbing,Final,Fixtures Complete . ,• 4'67 S Plumbing,Final Gas Test AS MN S _ _.9-57 T., - - '�- Z� Wiring,Final MAY 17 1�955T7 �VCC�6 Occupancy AIM.5 -1-S` FORM 210 3M 10-55 Costa Mesa Building Department 4474 APPLICATION FOR PERMIT '111 EAST 20th STREET BUILDING1 • COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY FOR APPLICANT TO FILL INReceipt No. Permit No. Builn Address 2225 Wallace gotta (tet.{,-& , I I 4522 Costa Mesa, California Received by Date Reed. Date Issued Nearest /s y� j ZS—S/ MAR 6 1957 Cross St Wilson Built Address Owner K,W.Koll construction Co., Inc. Mail Costa Mesa, California Address 2$26 Newport Blvd., Nearest Tel. Cross St. City Newnort Beach, Calif. No. NA5201 Zone I No.of I Type Group/ � / Architect or -4(�. Plans /� —1-k y/ Engineer Carlson and Mid ebrook Approved v l !/dA by Date Address Garden Grove. Ca]i r, CORRECTIONS City Lie. Contractor Owner No. Address same Legal I Lot I Description No, 6 I Block I Tract 306: (Attach Metes and Bounds) Size of Lot 60 x 100 I Now. oo Lots none Usei of No.mi Noom a /J a Existing Bldg. I Families I Rooms 53 I) Setback Line from Rear Yard Z Center of Street 50 Side Yard y DESCRIPTION OF WORK r New I X I Alteration I I Addition I Repair I I Moving I I Demolish I t9 Building No.of LJ Size 1188 Rooms 5 Stories 1 Exterior Wall I Roof — Covering stucco Covering rock APPROVALS I Use of New Building residence !y Foundation Location Inspector Date Forms,Materials, Under-Pinning ••••J 1 Frame: Fire Stops, .a Bracing,Bolts ;... I hereby acknowledge that I have read this Application C - and state that the above is correct and agree to comply Lath. Int with all City Ordinances and State Law regulating Al building construction. r. Lath. Ext Signature of Permittee Plaster, Int 04; Authorized Agt. ,f .dr Plaster,Ext. • • N Valuation Permit Fee $ a-4v — Masonry Reinforced N / Plan Check$ l 3 — Bond Beam $ (�/ 3� Total Fee G `--j $ 3/ '� FINAL O rcrnM 204 S-BP 2M 5-55 4 u c d J e • 4 J • 6 u L O. • • • Street-_ ., - PLOT PLAN Show location and distances from .- t- ^+ property line and between buildings. N • W C- 0 14 _ • -O N • - t .. - '-