HomeMy WebLinkAbout3094 YELLOWSTONE DR - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 6981 2/04/85 30053
CITY OF COSTA MESA '- • " - -- PERMIT NO. TRACT NO. LOT' NO. BLDG.NO.
' CONSTRUCTJION PERMIT -7(4 3/ - - - -
Project Andress • • lib. TYPE OF CONSTRUCTION ❑ NEW U ADD U�lq.J`TE TIO U REPAIR
Applicant's Mailing Address. • :� ��`r s, T�,• ❑'CONVERSION ❑ DEMOLISH ❑ OTHER ilk�• AP # (Zone -
• ''V DESCRIPTION OF WORK
Owner's Name - _ =4. ' - - ' . S Main Building: - Accessory Building: Z
R3vb �. Ct a�2 E 0
Address TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL T Front N
Arch/Eng. - License No. CI TENANT ❑ ELECTRICAL CI PLUMBING ❑ MECHANICAL B Rear -
I ^ Address- - C�� _�pp� - ❑ 'OTHER A - N
V , PROJECT DESCRIPTION SQ. FT. ��C1fl C Right - G
Contractor's Nam•F ri , �N •i� PfidMLSL_�kA17OCCUPANCY
Andress(mailing) ��•��Q��jj, �ry t'vTJ •, CON ST RUCTION TYPE
/ VALUATION$ �� 5 g Left R
City License No. QC_ZC,.� J ZONE GRADING CU.YDS. ACRES Ping. Ref.# t - Park.Fees $ D
U
i—__
LICENSED CONTRACTOR DECLARATION • Remarks: , Parking Req,/Provided I
I hereby affirm that I am licensed under provisions of'charter 9 (commencing B
with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E
my license is in f I fo ce .nd effect.
License Class_ •• -ns• o-C •.e I . PLUMBING , i • FEES Planning Notes: • M
Date7"4•�S Signature`1 _�� _\ - ' E '
WORKERS' COMPENSATION DEC LA RAtik N Bar Sink Showers T
hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink. I S
I Workers' -Compensation Insurance, or-a certified copy thereof (Section - — - - - -
• 3800, Lab. c 444:5 •
Backflow Irrigation Sewer Cap •• •- - ELECTRICAL - FEES
Policy No.��3_ compan a_t? Col - cvtD , -
Certified copy is hereby furnished. - llBathtubs I Sewer Connection Automatic Washer Transformer 0 15-50 KW
Certifie cop , filetl with the cijj-•��''BByiltling Di • .?� - - ❑ 50+• '
'ZrDate ApplicanT'� Clarifiers Solar Collectors Construction Pole Sub. _
EXEMPTION FROM WORKERS'.COMPENSA OND CLARA 10N - . Dishwasher ' •
-'Solar Piping - - '- - - - -
(This section need not be completed if the permit is for one hundred ($100) or P 9 Cooking Unit t ,Meter Oup to 100 amps
less). Drinking Fountains '
I certify that in the performance of the work for which this permit is issued, I 9 Solar Tank Dishwasher , Meter Clover 100 amps,
shall not employ any person in-any manner so as to become subject to the
Workers' Compensation Laws of California.: , Floor Drains' Swimming Pool w/Spa' Dryers ❑Gas; DElectric , ;Sub Panel ^
Date Signature . . _ '
NOTICE:If,'after making this declaration,you should become subject to the , Floor Sinks Urinal ' Fanl .Motors 00-1 HP O1'/a-'B
Workers' Compensation provisions-of the-Labor-Code,-you must forthwith-- - - - • - - -- -
comply ,with such rprovisions 0r -this- permit shall be deemed revoked. Gas Service Outlets' .Water Closet - •
CONSTRUCTION LENDING AGENCY - - F.A.U. Inc.Solar❑9-15 HP 016-15+ ,
I hereby affirm that there is a construction lending agency for the performance Interceptors - - Water Heater - • Fixtures 'Microwave •
of the work for which this permit is'issued (Section 309] Clv. C.),
Lender's. Name - - _ Kitchen Sink - •- ' - Water Service Device Boxes Pole Light
Lender's Address - Lavatories
OWNER BUILDER DECLARATION - Outlets Range '
I hereby affirm that I am exempt from the!Contractor's License Law for the , P_Tra '
following reason (Section 7031.5 Business and Professional Code: Any city or P ' • Switches Sign
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 'Roof Drains Garbage Disposal Standing Sections •
to file a signed statement that he/she is licensed pursuant to the provisions of - _
the Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑0.5 KW 05-15 KW Trash Compactor
'Division 3 of the Business and Professions Code) or that he/she is exempt - P
'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 Reinspection Fee $25 • Issue Fee - • $ 3 - '
enalty of not more than five hundred dollars ($500). - •
.
U I, as owner of the property or my employees with' wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $'3 -
compensation, will do the work,and the-structure is not intended or offered - •
FEES -
for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to,an owner of a property who builds or improves Boiler ' Hood or Type I 0 ,
thereon, and'who does such work himself/herself or through his or her own : Zoning Approved By Date
employees, provided that such improvements are not intended or offered for Canopy Type II D •
sale. Duct-Under Ground
If, te however,wthe will
building improvement of pro i sold within one yearofcom- Application Approved By • Date
pletion, the owner se have the burden of proving he/she did not build or im-
Drove for the purpose of sale). Duct-Structural Refrigeration System Application Issued•By � Date Z v^" •
I, as owner of the property,am exclusively contracting with licensed con-
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU 0100,000 BTU Sl MARY OF FEES
The Contractor's License Law does not apply to an owner of property who - BUI LDING PERMIT $ ..0•or) SMIP $ • SO
builds or improves thereon, and who contracts for such projects with a con- • Exhaust System 0 Multiple 0 System Repair/Alteration _
tractor(s) license pursuant to the Contractor's License Law): • PLAN CHECK $ PERMIT
0 I am exempt under Section - B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ ISSUANCE $
Date Owner - Heating System& Ducting
PLAN CHECK $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,00067E 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- PLAN CHECK $ MICROFILM $ -"
sentatives f this city to en upon above-mentioned proper for
y MECHANICAL $ TOTAL FEE $ 3°'SO
inspection es. ^]( QC
Signature ! Date e'4
Drivers',Li cense or SS ��� Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $
CMF 0865-46 rev, 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor -
POOL'& SPA
CONSTRUCTION AND PLA NIN f
APPROVALS Permit# ����`3/ Date Inspector APPROVALS Permit Date Inspector
1.-Temporary Electrical Service or Pole•- , 52. Pool & Equipment Location
• 2. Soil Pipe.Undrgrnd. - . ' 53. Steel Reinforcement
3. Electrlcal.Conduit•Utility-Undrgrnd. • - 54. Forms
4!Electrical,Conduit-Undrgrnd. 55. Electrical-Bonding
5: Steel Reinforcement- 1.7 56. Rough Plumbing & Pressure Test
6.'.:Electrical•UFER Grnd. • •� 57. APPROVAL TO COVER-GUNITE
7. Footings ' • 58. Electrical Conduit-Undrgrnd.
B..Fobndation - 59. Gas Pipe, E Undrgrnd., Test • •
•
9: Water Pipe-Undrgrnd' •
60. Backwash Lines, P-Trap, E 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 D 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. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test -
36. Hood or Canopy
37. Final Factory Fireplace •
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final ' •
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation - -
44. ,Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
•
48. Special Requirements Completed /
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY
No. Date
. f'crnc- Ir-
- 13595 IC. - C�L,Ltfi dt0
JAN 1 01961
COSTA MESA BUILDING-SAFETY DEPARTMENT • FINANCE DEPT.
P.O.BOX 317 COSTA MESA.CALIFORNIA
CITY OF COSTA MESA
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING 3094 YELLOWSTONE DRIVE
ADDRESS cc��11p
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. I 1R
OWNER KWK CONSTRUCTION CO., INC . PERMIT.25%9NO,
MAIL RECE}�VED BY DATE REE,�DEIVyyD DATE ISSUED
ADDRESS 1555 PLA CENT I A AVENUE M I /2- 7-' b I D I .Thai 1 1. 1961
CITY 'NEWPORT BEACH, CAL I FTNo.6-3Cc nn7 ADD EISS
AR' -ECT LIC. COSTA MESA. CALIFORNIA
OF INEER NO. n -
ADDRESS • ZIRE .E 1
FIR E TV PE GROUP r ljP
CONTRACTOR K. W. KOLL LCST AN-O.61195 BYPROVED DATE
ADDRESS 1555 PLA CENT IA NEWPORT BEA CH ZONING
LEGAL I LOT I I R
4041 ZONE I NO.OF I USE OF NENP 1LI@ Pain•
DESCRIPTION NO. I- BLOCK TRACT -1 PLANS 2 BUILDING/ att gar.
A.P.NO. none - APBY
W.L•D• (�� DATE 1-6-61
SIZE7 EVES
I NO.OF 6L REQU RED ALLOWED
ARDS
SFF LOT 60x100 NOW ON LOT OT
USE OF (CENTER LINE ST.) / 0 /7
EXISTING BLDG. FRONT L� FT. i D .33 .
SETBACK LINE FROM 42' REAR YARD 281
CENTER OF STREET L R.SIDE �FT. IN.
SIDE YARD I LEFT 5) 1 RIGHT 51 L.SIDE "FT. IN.
DESCRIPTION OF WORK (�
REAR /- FT. IN.
I X II ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
SIZIEDING 14855F ROOMS 7 STORIES 1
EXTERIERINORG JTWALLUCCO (ROOF
COVERING ROCK
COV
USE OF BUILDING AND WORK TO BE PERFORMED A L
SINGLE FAMILY RESIDENCE AND f"
ATTACHED GARAGE PLAN NO.
4-D �� .f�.�
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRE AND ACME TO CO -
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND TE LAWS GULATING
BUILDING CONSTRU TION. VALUATION L
SIGNATURE OF/ / PERMIT FEE $ �J �-
PERMITTEE71,1. 41,"4/ ,y/ ''77 _
$ /�` // PLAN CHECK $ //�5 n
AUTHORIZED AGENT yp
TOTAL FEE $ ,A,,,/,..5y
•
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATIO FOR STRUCTURAL PERMIT 50 Tl
• P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 R1-1h7 I /nc/RI R
1RECEIVED BY PERMIT Ai0 51188
For Applicant JtooFill in Completely� J --�Usee Ink
�+Only
C / �/ 1�1 11 1
ADIDRESS 30 /, wino
J f V Ar C V A.P.A.P. NO. kik 1 07 L�`- \ „L/(�.`/
OWNER OR -p �� AJ / //} ADDRESS Ahl4 et..Lo({JJI (JAL
TENANT /�-D, frflLe5 ( /�}JZ/ y [
MAILING !� UNIT OR
ADDRESS /)c 11 ye ad44,6 •�,ve SPACE NO.
T R.N__ O._ 1 LOT 2. i7 BLK.
,�}}''77 ,,/ TEL. ��,�i LLQ
CITY LV�� l�l�e5 ysr NO. NEW ADD ALTER REPAIR MOVING DEMOLISH
CONSTRUCTION
LENDER
BRANCHQ II .��•RS ^pi'
OWNER L. (. rIV
ADDRESSt- ale730
ARCHITECT TEL. USE � $
OR ENGINEER NO. (
ADDRESS ZONE NP.‘ TYPE GROUP
APPROVED
CONTRACTOR4N 12..e npie re. _BY DATE
ADDRESS/<4 Z &4:940 en6tAt 2_u.
_
TEE. CITY R//LV f 'o''I NOL9 y.... 0/ ! .
STATE{{ CITY D 6 APPROVED SETBACKS
LIC. NO. 2 2. ( 1 '2 LIC.NO.
W SIZE J INO.OF BLENDS. (FROM 1J.STREET)
0. OF LOT NOW ON LOT FRONT FT.
Q USE OF
Fr, EXISTING BLDG. R SIDE O FT.
N
FEl.
Separate permits are required for L.SIDE GO FT.
C electric,plumbing and heating work. REAR O FT. -
f , USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
'C .
Q a YV �'Cz oro a`4 DATE
d /^s. •h/�/1 L[XT ( ' , \\ �l //a APPROVED r�
>"' ( l_.f/ertnt Lf /V ( ry W/9"_.l RVPR('1 R IZ DATE[hie
cd
-i
a I hereby acknowledge that I have read this application and state P
`/
a that the above information is correct and agree to comply with
O. all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of o
the State of California.
a. m
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 D 0°
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 a 1^
VALUATION PERMIT FEE $ T y� 'J
and Professions Code, Division 3 Chap =r 9. m
Signature • i / teb I PLAN CHECK $ ^
o t
Permittee __ /. G/ $ TAX $
/ r LL M
Authorized Agent Date /— C 0/ TOTAL PAID $ B.
/� U V
OWNER MR. CHARLES CLARK DATE 1/5/81
JOB ADDRESS 3094 Yellowstone Drive BUILDING PERMIT NO. 51188
G=ENI,ERAL CONTRACTOR Dan Crunpton DESCRIPTION of WORK Blockwall
O . 141-072-21 LOT 22 TRACT 4041 FIRE ZONE VALUE E 800.00
—INSPECTIONS Signature Date TYPE GROUP ZONE Rl
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR
Dote Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER ❑
ROUGH WIRING ��J Heating and Vent. •
X TRENCHES ler FORMS STEEL REINF.gt"/n6Y
tf FLOOR SYSTEM •
/
BOND BEAM Ei STEEL REINFORCE n
9 SHEATHING
FRAME AND FLASHING
❑W❑ LATHING - IN n OUT n
rO PLA' 'R. BROWN COAT _
aS_ 1R AL, FINAL 710/�/ Electric
HEAA TING. VENT., REFRIG. AND A.C., FINAL
PLUMBING. FINAL AND GAS TEST n
ELECTRIC, FINAL �e1
BUILDING, FINAL W� ��