HomeMy WebLinkAbout3074 YELLOWSTONE DR - Building Permits 4.
CITY OF COSTA MESA -
4a4k BUILDING DIVISION
nik
: „„•., DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
1.4111 •
601-01105
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ccaUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BJob Address: 3074 YELLOWSTONE DR Status: ISSUED
Suite: Applied: 07/17/2001
Vicinity: RESIDENCE ONLY Issued: 07/17/2001
Parcel Number 14107216 Zoning: R1 R1
Applicant: CASTLEMAN, MICHAEL ISSUED BY:
Address: 19113 S HAMILTON AVE
Phone: (310)527-6770
GARDENA,CA Zip: 90248
Owner: BAMBOAT, HORMAZD R
Address 3074 YELLOWSTONE DR •�
Phone: y
COSTA MESA,CA Zip: 92626
Contractor CENTRAL ROOFING COMPANY Y� 3•
Oh
Address: 19113 S HAMILTON AVE
Phone: (310)527-6770
GARDENA,CA
Zip: 90248 License: 684960
Arch : Eng:
Address: Address:
Phone: Phone:
•
Zip: License: License:
SCOPE OF PERMIT
REROOF RESIDENCE ONLY:T/O EXISTING, REPAIR SHTG AS NEEDED,FELT PER MFGR SPECS,25-YEAR COMP
SHINGLES ON THE PITCHED PORTION.B.U.R.ON FLAT. 26 SQUARES
FEE SUMMARY
Plan Check: $0.00 - Calc Valuation: $4,300.00
Permit: $111.25 Claim Valuation: $4,300.00
SMIP Res: $0.50 •
SMIP Corn: • $0.00
Other: $0.00
Inspection: $0.00 - -
Total: $111.75 .
PLANNING &ZONING ' -
SETBACKS -MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 .Rear 0-0 'Left 0-0 Right - -0-0
PARKING Existing: 0 -' Required: 0 • Proposed: 0 -
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)7545626
2448.48(8/001
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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: /_,)�-�,,/
Carrier: 4TtvTC FIND Policy Number: 15S"VN"0I
(This section need not be completed 1f 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 370 of the Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: ,Q- Date: to 6
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($100,1100),IN ADOmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F 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 Professions Code,and my license Is in full
force and effect.Lic.a ( 5�tAkr„
Y Class a PK-
Contractors Signature: I•/!1 Lo n.. Date: 7117l)
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).
Lenders 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 drivers license. 0 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)feel 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 fore for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? D Yes U No
(Section 65850.2 of the California Govemment 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 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑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.
l.YzO ' aWreOf
�, Legal Owner(s) —7/i7 6(
And/Or Authorized Applicant D to
y0Ma A INSPECTION TYPE PATE INTr1AL$ CODE t INSPECTION TYPE OATS AL
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 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
• F ES RECEIVED
JAN 1°1261
COSTA MESA BUILDING-SAFETY DEPARTMENT 1111ANCE DEPT.
• P.0.BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
FOR APPL/CANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING 'I
ADDRESS • 3074 YELLOWSTONE DRIVE
COSTA MESA. CALIFORNIA fOR OFFICE USE ONLY _
RECEIPT NO. PERMIT NO.
OWNER KWK CONSTRUCTION Co ., INC I I-10 e`de{n
MAIL ftECEI HD BY DATE CEIyEq BATE IA3�
ADDRESS 1555 PLA CENT IA AVENUE I /— oj—l' I�hIJ 1 j 1961
TEL I BUILDING
CITY NEWPORT BEACH CALIF No. -3227 ADDRESS
ARCHITECT LIC. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
FIRE �/?/3'
ADDRESS ZONEIRTYPE GROUP.\JI- (J/yf{
CONTRACTOR K. W. KOLL LSTATE APPROVEDIC.NO. 1195 BY DATE
ADDRESS 1955 PLA CENTIA NFWPORjIi,ACR ZONING q
LEGAL LOT 40 111 ZONE I NO.or I USE OF NE%PI & i •
DESCRIPTION I NO. 27 I BLOCK I TRACT R-1 PLANS BUILDING w/ att gat .
APPROVED 2 /_/ B`_.
A.P.NO. none BY 1131) �i DATE• 1-00]. . -
SIZE 6OXIOO NO.OF BLOCS. YARDS V EVES
OF LOT I NOW ON LOT 0 �(p�,REQUIRED ALLOWED
USE OF (CENTER LINE BT.) /y (�
EXISTING BLDG. FRONT 0 FT. CI D 33.6 IN.
SETBACK LINE FROM 1+0I Q 1101 ttl
CENTER OF STREET REAR YARD 3 R.SIDE J FT. IN.
SIDE YARD I LEFT 51 I RIGHT 51 L.SIDE FT. IN.
DESCRIPTION OF WORK REAR 3-7 FT. / D IN.
NEW I x II ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
S BUILDING 14078E NO.OF ROOMS 6 STORIES 1
EXTERIOR Wq�L I ROOF COMPOSITION l/{r
COVERING JTUCCO COVERING SH I N(:I FS rn J
USE OF BUILDING AND WORK TO BE PERFORMED J
SINGLE FAMII Y RFc IDEMCE AND
ATTACHED GARAGE PLAN No . 2-BR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IB FOR THE
AND STATE THAT THE ABOVE IS CORRECT AGREE TO COM.
PLY WITH ALL CITY ORDINAN ES AND STA LAWS R LATINO PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCT N. /T� VALUATION
SIGNATURE OF`�/���� y��/ PERMIT FEE $3 �
PLAN CHECK S //
PERMITTEE !/ • �J
$ / / "" ��
Jy
AUTHORIZED AGENTSeaTOTAL FEE $ tr�
3821 .5
'` COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A'P !CATION FOR BUILDING PERMIT
For Applicant to Fill in Completely Q�
R :IV�e BY D'TE EIV • DA IS .
BUILDING '/ I/ //ADDRESS 1 I.... /
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SIZE NO.OF BLDGS. (FROM C/L ST/DT)//}/,. ,,/
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I hereby acknowledge that I have read this application and state pl`K
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
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C/) the State of California.
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I hereby certify that I am properly licensed as a contractor under SO. FT. 'pM' 0.-
the
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER ALUATION IS FOR j
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 0
CC
am exempt from the provisions of the State of California Business
VALUATION
and Professions Cncie,-Efivision 3. Chapter 9. 0
/ - PERMIT FEE $
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TOTAL FEE $
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'• COSTA MESA BUILDING-SAFETY DEPARTMENT
I P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
ION FOR BUILDING PERMIT
For Applicant to Fill in Completely RE EI D Y DATE RECEIVED OA PERI
SUE
BUILDING �/
ADDRESS /' 74 ]'E�LaW STSr(/C /L i `>2 ill
• PER TN
OWNER A.P. NO.
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OI hereby acknowledge that I have read this application and state /' ��
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V) the State of California. m
UN
Z I hereby certify that I am properly licensed as a contractor under SO.FT. \\ O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN pER VALUATION IS'FOR
Chapter 9, end that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT-FEE ONLY: e
am exempt from the provisions of the State of California Business m
and Professions Cone. Division 3,Chapter 9. VALUATION O' m
PERMIT FEE $3 N
Signature of O
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Permittee $..c..•-••••----..------- PLAN CHECK $� E
en `o
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TOTAL FEE •/
OWNER P'UUNT'AlN VALLEY EAFEIST CHURCH DATE 2-11-75
JOB ADDRESS 3U(4 Yellowstone Dr. BUILDING PERMIT NO. 39559
_ GENERAL CONTRACTOR Owner Bkdr• DESCRIPTION of WORK patio Cover
t' AP No. 1l41-072-16LOT TRACT FIRE ZONE VALUE $600.00
p\ I `ECTIONS Signature Date TYPE V GROUP J ZONE R1
-5 -
SUBCONTRACTOR PERMITS ISSUED
GAS
Date I Number Signature
WATER
u Plumbing
ROUGH PLUMBING
PROP. $WR. LINE HOUSE CON.
1 SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES 0 FORMS 0 STEEL REINF. 0
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE 7
SHEATHING _
FRAME AND FLASHING
LATHING - IN 7 OUT fl
PLASTER, BROWN COAT
ST?JICTURAL, FINAL Electric
I, ANG, VENT., REFRIG. AND AA.C..r-�FINAL -
Pu BING, FINAL AND GAS TEST
ELECTRIC, FINAL y/A
BUILDING, FINAL A*v 7 r/ It 23
• 3958.9
,V -EB i1-75—: '00 2811", ****12.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT
RE EI ED BY I DJA.tTE RECEIVED DATE ISSUED
BUILDING Rf //-7r I/
ADDRESS 307+ Yellowstone. Drive PZ//-'fvr
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OWNER Fo +Hi •n M • .MTI • A.P.NO.( "077= al
MAIL o Cny BUILDING
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ADDRESS P.O. Box 8506 Fount.Valle. ADDRESS J
CL W W TEL 97' TRACT 4/ LOT2+/ BLOCK
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CONSTRUCTION NEW
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JD BRANCH ,r
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�46 'ZFCr. APPROVED 5 2J//Hi
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W= TEL Zribi PLANS BUILDING USE OF NEW
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Zi- CITY 0OCI-D MP', No979-2977 1 2 rQtll�Cz
CO O STATE CITY YARDS APPROVED YARDS APPROVED
to CC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
SIZE 60 X 100 NO.OF BLDGS. 1 (FROM C/^�1l STREET)
OF LOT NOW ON LOT FRONT' AHTTF T. FT.
USE OF home i Sam ly
EXISTING BLDG. R.SIDE F(l/ FT. FT.
I— SIZE OF patio cover OF
Z NEW BLDG. ROOMS STORIES L.SIDE i3 FT. FT.
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Q VAR. # DATE
m ✓ P e-441/4"-ell C.U.P. W APPROVED
co BPPROVEDNUv
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U I hereby acknowledge that I have this application and state h
Mat the above information is correct and agree to comply with • / -
all laws regulating building construction, and I shell not employ
Hany person in violation of the workman's compensation laws of TAX
to the State of California. m
Z I hereby certify that I am properly licensed as a contractor under SQ. FT. v 1 �'� o
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR b
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
LC
em exempt from the provisions of the State of California Business VALUATION e_2. B
and Professions Code,Division 3, Cha ter 9. �,,
II a a PERMIT FEE $ D
Signature of /`- /'�) r m
Permittee 2� $ L[�l�V PLAN CHECK $ E /\
v
/2 °- p/�
Authorized Agent
TOTAL FEE $