HomeMy WebLinkAbout3087 YELLOWSTONE DR - Building Permits Y
x`101 MF 9 CITY OF COSTA MESA
BUILDING DIVISION
• •r.,,, ,. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
44 PERMIT
a , 1. 04-01179
•
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 3087 YELLOWSTONE DR Status: ISSUED
Suite: Applied: 06/30/2004
Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 06/30/2004
•
Parcel Number 14107308 Zoning: R1 R1
Applicant LEHMAN, JEFFREY ISSUED BY:
Address: 2415 MARGARET DR
Phone: (949)646-3571
NEWPORT BEACH,CA Zip: 92663
Owner: DILTS, JEFF A •
Address 3087 YELLOWSTONE •
•
Phone: -
COSTA MESA,CA Zip: 92626
DA*
Contractor: J S L ROOFING INC
Address: 2415 MARGARET DR
Phone: (949)646-3571
NEWPORT BEACH,CA
Zip: 92663 License: 747706
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL OSB, FLET AND 30 YEAR COMP SHINGLES. INCLUDES ATTACHED GARAGE.APPROX 2000 SO.FT.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $4,000.00
Permit: $97.25 Claim Valuation: $4,000.00
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
• 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)754-5626
2445.46(6/00)
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'corn.:nation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My works isi pan -tion Insuran•• =rife .nd policy number are:
Carrier: , �,AV AZ Policy Number.
`(This section need not.. :7:7-0:::. :permit valued a/a hundred dollars($100)or less.)
�
] I certify that in the berth .. ' /the work for wh'• this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
'\ compensation laws of C,I • I and agree th. F should become • : t to the workers'compensation provisions of Se Ion 3700 of the Labor Code,I shall forthwith
comply with these p • r ^-,I,3� 0
Applicant Signature: ,,I✓//ice Date: l IN
WARNING:FAILURE TO '-curw-- r AS''. 'ENSATON COVERAGE IS UNLAWFUL AND SHALL SUBIECr AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE 15100,..,IN ADDRI• TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES,
59
LICENSED CONTRACTORS DECLARAT •N:
I hereby affirm that I am licensed u;or•"visions of C t.•ter 9(commend •with Section 7000)of Division 3 of the Business and Professions Code,and my license Is In full
Conand effect.Lic.e / Class#
tractor's Signature: �1�Sa" Date:
50 O' /
CONSTRUCTION LENDING ' E'CV:
❑ 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 Cale).
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(commenting with Section 7000)of Division 3 of the
Business end 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(5500).):
❑ 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 properly 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 feat 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 ihIrty-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 Wit 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 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 lime during a reported year a quantity of hazardous materials equal to or groator than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
_ _ _ .._
_._� —.._ --00.... ... ___
2 Does or will the applicant or present or luturo building occupant need to file a registration form for acutely hazardous materials? ❑Yes 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.
—...._._...P...._—,_ _ ..__ _ _..._ —_._
4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No
.._..__will _i...__. _ ...._.i_..._ —__O...___ .
5 Does the applicant or ior n building occupant at efor the work ntch is the subjectage c this Application a emit for such construction or modification
From the South Coast Air Quality Management Disirid or from any other air pollution control district or agency? Yes �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? 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 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 COMPL ' CE AND A 'TION 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 comet with all state I .nd city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described prope for inspectio •••es.I agree not to occupy or allow occupancy of any building authorized(? 01
by this permit until final inspection.
/ / • at : Of Le.: ( ,•ner(s) 0) Date
An, n Authorized Applicant Date
FOOE• ..-I' :044.is I. Oa MALI PON( INSPECIONTYPt BM Ri1IDAl4
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof i 21.0,„ 210 Final Electrical
201 Final Block/Retaining Wall •04 ' ) e z e 212 Final Fire Prevention _
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Bullding/Occupancy
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 5943 9/23/B7
CITY•r7F COSTA MESA(,�(j,ON R TION PEM MIT PE T NO. 9 TRACT NO. LOT NO. UNIT NO. - 2Bo5� TI,
Project AddT8Ss ?l) �t /_ Tel f°I-O S ft Pre-- �D� • / '
?,ppliaHt's Mailing/Address TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION �j REPAI R
(a '.,
Owner's Name ' 1n OW' a ., ' S PhoneS'P7.3 ❑ CONVERSION ❑ DEMOLISH ❑ ELDER A.P.# Zone
DES PJIOJ�Vv OF WORK/USEQ�F BLD A Se---
Address •n al–IZ – 7.0tQ - ..K10.c-=, X11 t. eaS• ;trim. 1,11 e-• 4 S Main Building: • Accessory Building: Z
Arch/Eng. License No. TYPE OF PERMIT U GRADING LLLi FOUNDATION U STRUCTURAL T Front 0
Address L,_ ,/ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ M CHANICAL B Rear N
Contractor's Name <` -�"�Or I�(Sdfiy/7 aiC Phone9 "C230 ❑ OTHER O 'Y[ A
/! PROJECT DESCRIPTIOFL 50. FT. p �U tJ'O OCCUPANCY C Right N
Address(maiting)90,e–A . nt. 7'' S.A- 9-2701 ��� K G
G./�� / / J INSTRUCTION T PE VALUATION$5 S Left R
City License No. Y 7 • E RADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.4 Parking Req./Provided E
Q
I hereby affirm that I am licensed under provisions of Charter 9 (Co.. encing marks: Planning NOtei: M
with section 7000) of Division 3 of the Business and Professions •de, and
my license is in fu for • ..d effect. T
•
I Ucen•Cies _I _ (? 'cg nse N. S •im S
arair
Date ���f Signature'. 4 a / PLUMBING FEES
WORKERS'COMPENSATION DECLARATI�'r' !•
hereby affirm that Mayo a;certificate of consent to self-insure or a certificate Bar Sink Showers _ ELECTRICAL FEES
1 Workers' Compensation Insbrance, or a certified copy thereof (Section
Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW
300, Lab. )v C/' / /^ ) 0 50+ KW
PolicyPoNo•/1 �"'i TIP - Company 77' i FP I'LL nit/ Backflow Irri• gation Sewer Cap Construction Pole Sub.
y,Certified copy is-hereby furnished.
pt7 Ce led co y irriff yd with the city/1'44-114Div's' n. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date -'/ -7'i / Applicant - '
EXEMPTION FROM WORKERS'COMPENSATION D T26N Clarifiers Solar Collectors - Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for o' e huniTred($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
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 Drinking Fountains Solar Tank Fan Motors 00-1 HP 0114-8
Workers' Compensatrtin Laws of California. —
Date i Signature - Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE:If,after making this declaration,you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions orhthis permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Li ht
I hereby affirm that there is a construction lending agency for the performance 9
of the work for which this permit Is Issued (Section 3097 Civ. C.) Interceptors Water Heater
P Outlets Ran e
•
Lender's Name 9
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION Disposal
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage
following reason (Section 7031.5 Business and Professional Code: Any city or _ 9Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P–Trap LaundryTrays
any structure, prior to its issuance, also requires the applicant for such permit Generator 00.5 KW 05-15 KW Trash Compactor
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law (Chapter 9(commencing with Section 7000) of - -_ -- __
Division 3 of the Business and Professions Code) or that he/she is exempt --
,erefrom and the basis for the alleged exemption. Any violation of Section
)31.5 by any applicant for a permit subjects the applicant to a civil •--
' „enalty
—
enalty of not more than five hundred dollars($500).
D I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
•
compensation, will do the work, and the structure is not intended or offered Reinspection Fee $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
_
thereon, and who does such work himself/herself or through his or her own - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden Of proving he/she did not build or im- Duct-Under Ground Building Approved By Date
prove for the purpose of sale). y/y
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By_. Da, a/ •
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUIv]N1ARV OF FEES j1
builds or improves thereon, and who contracts for such projects with a con- Q,,,((}�'
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ t�� SMIP $ LSD
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
O l am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG 4 Fire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System 8( Ducting Registers
PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000 BTU ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, and hereby authorize repre- MICROFILM $
sentatives of this city to enter upon the above-mentioned property pfor PLAN CHECK 50% $ -�p
inspection puclpeSasi ,iz3–d 7 MECHANICAL $ a0•Sa
Signature //se or lI Date/ d TOTAL FEE $
Drivers' License or 5 # Reinspection Fee I $15 • Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
I 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 OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings t
d: • 58. Electrical Conduit-Undrgrnd.
8. Foundation : 59. Gas Pipe, 0 Undrgrnd.,Test i
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# '
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush •
24, Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil .
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical '
27. Frame and Flashing 76. Dry Standpipe .
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL I
30. Drywall Nailing HEALTH DEPT. REQUIREMENT -
31. Plaster Brown Coat 79. FINAL INSPECTION ,
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED , . -
33. Final Electric Notes: i
34. Final Heating & Air Conditioning •
35. Final Gas Pipe-Test
36. Hood or Canopy .- - - ,
i
37. Final Factory Fireplace
38.' Final Plumbing - -
39. Water Service-Final '•
40. Gas Service-Final
41. Solar Domestic-Final Ji
42. Backflow Preventer - • '
43. Backflow Irrigation .: •
• 44. Landscape Irrigation System I . ) -
45. Sound Attenuation EXPIRED I ,
46. Handicap Regulations tncon pl. - Luspcctions • u
47. FINAL STRUCTURE & BUILDING Date J. A Sg
48.1Special Requirements Completed LI •
49. Electric Release to Edison 1`
50. Gas Release to Southern California Gas Co / /
51. CERTIFICATE OF OCCUPANCY - '
No. Date
OWNER t.L1CV14k, Dana D. DATE 6-11-74
JOB ADDRESS 3087 Yellowstone Dr. BUILDING PERMIT NO. 38528
GENERAL CONTRACTOR Master Rl�f rs.Inc. DESCRIPTION of WORK
pdd Fem.Rm, to Res.
/ 'o. 141-073-08 LOT TRACT FIRE ZONE VALUE $7 OO.00
L. ECTIONS Signature Dote TYPE V GROUP �z ZONE
4 SOIL PERMITS ISS ED
GAS SUBCONTRACTOR
Date I Number .1 Signature
WATER
Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING •
TEMPORARY SERVICE OR POLE
UNDERGROUND fl POWER El v
ROUGH WIRING /- Heating and Vent.
TRENCHES FORMS [5k STEEL REINF. ® _ !o'/G. ii
FLOOR SYSTEM tk7 /`.-/C/r7q
BOND BEAM n STEEL REINFORCE {"I
SHEATHING 1<-C3 I'-Jt-7
FRAME AND FLASHING r) ll..YY��F//
LATHING - IN n OUT [� 4 s q'c/-] '
PLASTER, BROWN COAT J�
TURAL, FINAL '
HL. iNG, VENT., REFRIG. AND A.C., FINAL /J ��LTIW_ �.yl `� j
PLUMBING, FINAL AND GAS TEST • erar�gy/�
ELECTRIC, FINAL el/LyL
_
BUILDING, FINAL '� 1"v1_l )//.� •
_I
..-1 38528 PAIOnn
:I!N I 1-7iUU
65fl'n ***/.57.51
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
\1
• A LI ATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
REC IV B ye DATE RECEIVED DATE ISSUED y
ABUDIDLRDEINSSG 3 0 2,7 „yavigidy.4 .c Ace. . . C ec-if-74 b—//- 7 V
OWNER --intern id ipeLezepENA ji N.0, ry,
A.P. NO. Pi/-07g-- ,-5•I6 b 0, es
BUILDING
MAIL
, ADDRESS ADDRESS 32 s7 /V-1wats-zitag tic
z .
w. TEL.
13. L.) CITY e...00Vet 7}3-442-&-/ NO.SW-4/6Z,5 TRACT 440 / Loice BLOCK
1- 2
Z < CONSTRUCTION ci 8 i NEW ADD ALTERPAIR MOVING IDFMOI ISH
- I- LENDER
0 co X
a- 03
_J 0 BRANCH St 541.4.24.ryn..., &K.-GAL - '
_J(9 OWNER imaitie.--/ 0
•
< ill ADDRESS /ca 3 ci (50 (-4,444,..An,..a.•... _ 64-2, •
co -J VALUE -z *,eii..-
.03 ARCHITECT TEL.— USE /CA fh C)/7) $
-I < .---
OR ENGINEER NO. •
FIRE
Liz LC ADDRESS ZONE Y PE f DATE /17/IT en_
a Ly APPROVED
lb Z CONTRACTOR 7af..42.664.zs \-011-4. a BY
-10
a3 z
:it ADDRESS -7 g yes 2,1224....sc. 34.
w uj ZON ,.. No.C/F USE OF NEW
0 I fit TEL. ,. I PLANS BUILDING _41 A if a ,
Z I- CITY 01:
NO. _ . 7, 2 ites. -
-
Lu 0 STATE CITY YARDS APPROVED YARDS APPROVED
fr)CC LIC. NO. „2 7 ' '39 LIC. NO. MAIN BUI DING ACCESSORY BUILDING _
DO I (FROM WI_S EETJ/ eolf/
SIZE I NOW ON LOT i FRO
NO.OF BLOGS.
OF LOT M- 4 al e FT.
....„
USE OF
EXISTING BLDG. 6 -1/0fretri,4C,IFT, B.SIDE e tazder, FT.
H SIZE OF NO.OF
2 NEW BLDG. . ROOMS STORIES / L.SIDE57;. FT.
< EXTERIOR WALL ROOF
C.) COVERING COVERING REAR •••<‘,11c FT.
_ FT. , .•
-I USE OF BUILDING AND WORK TO BE PERFORMED
0- DISTANCE BET. BET.MAIN&
0. _vmAARI Np.#.#9L D a S. ACCESS.SLOGS.
cr tinfy,var.„. ,a,a3=4,7,„,fr. DATE
c.u
O APPROVED
I- APPROVEZdho Pe"
C/3 ..--EtY
I-
2 fit IE
DAT-
0 / A7-
-
H
I 31
ci I hereby acknowledge that I have read this application and state n
D that the above information is correct and agree to comply with • '
CC all laws regulating building construction, end I shall not employ
I- any person in violation of the workman's compensation laws of
f./) the State of California.
lLo SO. . (..62-ylr yr' /
Z FTi /74- -1g
74
- I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN DER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABL HING A PERMIT FEE ONLY: a
am exempt from the provisions of the State of California Business i M
VALUATION _
_o
and Professions Code,Division 3,Chapter ea
PER
FEE $ c•
I
•
.55 D
Signature of
i '
Permittee r,i
g.
24-41.1&•-•4•-.. IC/7 $ 1.--7301, PLAN CHECK $ T
Id
Authorized Agent ., *2__ is
TOTAL FEE $ G /
•
•
1_3537 FEF RECEIVED
STA MESA BUILDING-SAFETY DEPARTMENT DEC 291960
P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION Fa PElivINA MESA
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 3087 YELLOWSTONE DRIVE
COSTA MESA. CALIFORNIA FOR OFF/CE USE ONLY
OWNER KWK EON STRU CT ION Co . , INC. I RECEIPT NO. 113537
MAIL RECE F BY DATE RECEIVED DAATE. ISSUED
ADDRESS 1555 PLACENTIA AVENUE ll�� ____, (/�. /- -.2t1 Liu; . a 196I
CITY NEWPORT BEACH, CA4,1F TNW-3227 BUILDING
ADDRESS
ARCHITECT LIC. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRESS
FIRE
A" �//iJL
[ ZONE TYPE ✓ GROUP �-{ T
CONTRACTOR K.W. KoLL LIC.ANO.61195 APPROVED :/
BY DATE
ADDRESS 1555 PLA CENT IA NEWPORT
I B1EACF' ZONING
C, 40141 ZONE NO.OF USE OF NEM L' L
DESCRIPTION I NO.LEGAL 35 I BLOCK I TRACT I1/4),,, I I PLANS ' `� BUILDING 6014/ ',/I
APPROVED L 1 t \'1 DATE 13 _\_ !jj'I
A.P.NO. BY LA) V 11 L
OF LOT SIZE 6OX 100 I NOW ON LOTS 0 REQUIRED YARDS ALLOWED
USE OF (CENTER FRONT LINE ST.) - `6 O 4 03a.4
EXISTING BLDG. /`Y/
SETBACK LINE FROM 401 351
CENTER OF STREET -e REAR YARD R.SIDE FT. IN.
I
SIDE YARD LEFT 5 RIGHT 51L.SIDE 5 FT. IN.
DESCRIPTION OF WORK
_, REAR 3 FT. IN.
NEW I X II ALTERATION I I ADDITION I
REPAIR I II MOVING I II DEMOLISH I
SIZE BUILDING 132OSF ROOMS STORIES 1
EXTERIOR WALL I ROOF COMPOSITION
COVERING JTUCCO COVERING SHINGLES
USE OF BUILDING AND WORK TO BE PERFORMED
SINGLE FAMILY RESIDENCE AND
ATTACHED GARAGE PLAN NO. 1-DR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT NO REE TO COM-
PLY WITH ALL CITY ORDINANCES AND ST. E L S REGUL INC PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. VALUATION
SIGNATURE
PERM IITTEE OF - Tqr/(_ Iv PERMIT FEE $ /02.� " $ /-36702 /PLAN CHECK $ 7
AUTHORIZED AGENT TOTAL FEE $ !l ,.��--
•
777
UWNtK rinil+bj IMAMS Lf; 'UMW UAIt 1'i'+'1'r
•, 'JOB ADDRESS 3057 Yellowstnne Dr. BUILDING PERMIT NO. 38661
-;GENERAL CONTRACTOR Owner .Bldr• DESCRIPTION of WORK Fireplace
'SAP No.141-073-06 LOT TRACT FIRE ZONE VALUE $ 600.00
'4 it iCTIONS Signature Date TYPE V GROUP J ZONE td.
50,6. PERMITS ISSMED
GAS SUBCONTRACTOR
Date I Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE fl HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES [.] FORMS Li STEEL REINF. C
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT n
PLASTER, BROWN COAT
STr 'TURAL, FINAL Flertric
HE G, VENT., REFRIG. AND A.0 , FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL [�
BUILDING, FINAL b2,o t_t-2.44
-_ 2866 I;
•
PAIL
- COSTA MESA BUILDING-SAFETY DEPARTMENT '° 1�"7I'c• �--in 7011- *:-y+:.:;C,5(
. J P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
AP I TION FOR BUILDING PERMIT
For Applicant to Fill in Completely
y/.,�'7 fj�� RE I E V DATE RECEIVED DATEplicantBU
ADILDINGDRESS306 / yaLDC.JSIL/L/��tM. �C/ �/ /-10 7
OWNER //a'Ey ,tieI1AyA/E �A%1 A.P.NO. I /I 072 OD IP A;}!7,N0•
MAIL /IQ 7� BUILDING II.I////// I��s-.+/'s+//b
Z ADDRESS3vp77&L/UG6/S/(/AI€ 2ja ADDRESS 3c 7 ,nz,US-ro— ,
a U CITY Caste r/ LCSA NOLu LLI H 1G-4ad TRACT '7 09, I/— LOT 3 5 BLOCK
CONSTRUCTION NEW A. DDS ALTER REPAIR MOVING DFMOLISH
Z Ha' LENDER \lX/-.
0.
J N BRANCH •
OWNER // P/2-rLE
C W ADDRESS �p� „ `�
CO-CO ARCHITECT TEL. USE ' iz PL/'TcG VALUE /09
J FIRE
OR ENGINEER NO. ,}1.
W a ADDRESS ` ZONE / `/`_TYPE GROUP V
J Q CONTRACTOR O dye �-0_ LLI C/e/— . BYPROVEt� 1 n{r DATE 7^la-�4•
m z /y/LLL"'
J a ADDRESS
LLI W TEL. ZONE NO.OF USE OF NEW TN.
0 r CITY NO. R ' PLANS Z BUILDING ALT
ZI-
- O STATE CITY YARDS APPROVED YARDS APPROVED
LU
to CO LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
0 O (FROM C/L STREET)
SIZE NO.OF SLOGS.
OF LOT NOW ON LOT R NT 5T. FT.
USE OF il
,to
EXISTING BLDG. R SIOF , 't/ FT. FT,
F— SIZE OF NO.OF 19
2 NEW BLDG. ROOMS STORIES L.SIDE FT. FT. —
C EXTERIOR WALQ^ ROOF Cf�a/L-
U S�
COVERING dVLC�/ COVERING '//(/�!T REAR FT. FT. C
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1 MAIN BLOCS. ACCESS.SLOGS.
Q /AIWA t G t LF SrA4•[7 G---n C URP,# APPROVED
I— APPROVED q- / /,
CO FY �./7'1-' DA/T/L'" / 7
O 1( �l
UI hereby acknowledge that I have read this application and state /
D that the above information is correct end agree to comply with tAX
CC all laws regulating building construction, and I shall not employ
I— any person in violation of the workman's compensation laws of
V) the State of California. w
? I hereby certify that I am properly licensed as a contractor under S0.FT. O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: G
am exempt from the pro ns f the State ofooffQgt�fornia Business
VALUATION
and Professions CO Is n ,ChapterL9.
N
PERMIT FEE $ a
Signature of / i ro
Permittee • 11 ref—, $ e / PLAN CHECK $ E
Ulllssss V �j] / U.
Authorized Agent TOTAL FEE $ t/