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HomeMy WebLinkAbout3100 YELLOWSTONE DR - Building Permits CITY OF COSTA MESA • r BUILDING DIVISION 4 :..,;a 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us giqkF FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BX09-00021 PERMIT TYPE B_MISC STATUS: ISSUED APN: 14107222 DATE ISSUED: 01/29/2009 Zoning: Ri, ISSUED BY: RMD JOB ADDRESS: 3100 YELLOWSTONE DR CM Suite/Unit: Vicinity: REAR OF HOUSE Primary Occ: 32 Const Type :?? SQ. FT: 437 Valuation: $7,044.44 SCOPE OF WORK: CONSTRUCTION OF A 437 SF ATTACHED LATIC PATIO COVER FOR A SFD. NO ELECTRICAL INVOLVED. OWNER: MACKPRANG, GEOFFREY M Address:: 3100 YELLOWSTONE DR Unit City/State: COSTA MESA, CA Zip Code: 92626 Phone: 949-295-4644 • APPLICANT: MACKPRANG, GEOFFREY M Address: 3100 YELLOWSTONE DR Unit: City/State: COSTA MESA, CA Zip Code: 92626 Phone: 949-2954644 • • - CONTRACTOR: OWNER-BUILDER License No. 000000 Address: Unit: City/State: Zip Code: Phone Cell: ARCHITECT: License No. Phone ENGINEER: License No. Phone FEE SUMMARY • Building Plan Check: $99.61 Building Permit: • • $153.25 Electrical Permit: $0.00 SMIP Residential $0.70 SMIP Commercial $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $254.56 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. COOE1, INSPECTION Tin min INTMAL5 CODE INSPECTION TYPE DATE INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 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 CI 204 Final Demolition 250 Final Building/Occupancy 2-2 .0 lO at— WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv, ..ense. 0 Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's No. pves: I,-10-I 2- CI I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tai bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized Carrier: by this permit,and that no building structure,scaffolding,falsework,or demolition (This section need not be completed d the perms is valued at one hundred dollars(8100)or less or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.341,Ttle 8.California Administrative Code). Policy Number: t, ❑ As owner-builder, I will not employ anyone to do work which would 't certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subjr 1 to the workers'compensation provisions of Section 3700 of Applicant's Signature Date the :bor C. e,I shall forthwith co .ply with these provisions. I- cy Division of Industrial Safety Permit Number: /iPtNI 'Signs HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: W•'-la"• : FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097•Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑No Lender's Address: (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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes',the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). f�as owner of the properly, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.), information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 10 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection pu.oses. I agree not to occupy or allow occupancy of any building oath• izedthis permit til final in section. —2–C1 7/ ,L4 vA . /_�-- ( — / • D CI �• -•—"bttegarOwne• r 3057• And/or Authorized Applicant Date Header(, Rafter(s) Rafter er DETAIL OPTIONS i 1 *4 i �, , Check the ones that apply: La Cover OB 1111C OD XE OF `/s olid Cover: ❑A ❑D ❑E OF a • 11 ...W.avVyweIvS/VSAV• U»>r ■r1� ✓v inasm0SW,tv wisest." .;; v ` fi n "LN?,,? EXTERIQRx ALOF- OUSEni4;Y _^ w Post Anchor Post Lattice Cover Solid Floor Cover Roof Covering 6-min 26 Ga. Roof Sheathing ,ora ,',' . Footing %� Depth Lattice FRAMING PLAN Flashing Roofing 12" Sheathing J; PAD FOOTING A Lattice _____ ---... ..,A: 75 ott max perpost rPost I I; � 6'min jRft er A--X Header _3: Rafter • Joist Han anger A. 4 Joist Hanger g Post Ledger ' t-SLAB Ledger th b SLAB FOOTING B o co 2% — h-* iab . ° m Slab 2% 2x6Min 2x Joist7Slope • • _ Slope Fascia / to Drain ��" Lt" to Drain //Existing // lift Footing L"�' t 8 g' at Anchors wallLattice Solid Roof I z-o' 6'6" 1 root Cover Cover Max Max Span . SECTIONS • EAVE CONNECTION C _ .ti` .e. s_. .» tx,"vCONSTRUCTION:MAT;ERIALSf"'-,-,: + '" : _` ^+1 .;j ,c( Joist *..j : 1f2'x 5' V Lag Screws 1 SPECIFY LUMBER: OF 0 Redwood 0 Hemfir GyP ®t6 o.c: -, 7 SPECIFY GRADE: No. 1 0 No.2 v`�t�� m.yS�' .�, • Joist CONCRETE: 2500.psi min.@ 28 days 0'44 V . H nger CONNECTIONS: ICRO approved or equal F_GO�' .,1�"Np��irres .;'-' ger 1. Roof covering: Slope:_12 �`SA0G-(l Q Q JO es �'s\ ` ' Lc c 81 D 2. Roof sheathing; Maximum span>�� (+ w,d` .., ' o. lattice: 2 x 3 @ S *o.c.: Y 2x2-6';2x3-8';2x4-10' St'c9+ ..,' Its t� -. _ Lsf•'. 0341/4 solid: -CCX plywo or 'lumber. 1"-2'-8";2"-8'-0" / _wi� t� • l� • 3. Rafters: 2 x ` @ Fr o.c. []-Single (gDouble 4 \told' 00-vote - Dummy Post _.,� p\voters, --Support Post 4. Header: x ❑Single ❑Double �,�s to ate" . 6:4 , T yf" Beyond 5. Ledger x (2x min) \C a o\\ 6. Fascia: x�(2x6 min „kw O e air qe� r RAFTER/HEADER E 7. Post: I-x�(4x4 min)Raise 1"min above slab surface irir• 19L4,044 d a,�`.LV. Root Sheathing ,,,,p or Lattice 8. Footing: 12 x 12 12"x12"min for up to 66 sf tributary area; 18"X ''3fli �,�9w, nbutary area Rafter IBr depth(Expansive Soil Zone ) o\� Q"' dfi� . Framingchor ` I% 9. Slab "thick(Expansive Soil Zone ) r.•to Each Block A 10. Connections: a. Joist to Ledger -Metal joist hanger 4 Header 2 X Blocking b. Joist to Header -Solid blocking with framing anchor Post Column Cap ,c. Doubled joist or header to post -(2) 1/2'dia. that bolts w/washers V JOIST/HEADER F yC Joist to Fascia -Metal framing anchors each side./ (min. capacity=0.5"joist span"joist spacing* 15) e. Header to Post -Column Cap isler Post to Slab or Footing -Metal Anchor/Post Base✓ g. Roof Sheathing -8 d @ 6" o.c. Edges and 12"o.c. Field ' CITY OF COSTA MESA o BUILDING DIVISION > •4 ,,,' r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER FI ”-+.e i J if K. • PERMIT !� P06-00013 ffi so (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cLUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3100 YELLOWSTONE DR Status: ISSUED Suite No Applied: 01/05/2006 Issued: 01/05/2006 Vicinity: Parcel Nunmber: 14107222 c Applicant: JOSEPH LARGURA ISSUED BY: Address: Phone: 714-556-1564 Zip: Owner: DANIEL, CHARLES E Address 3100 YELLOWSTONE DR Phone: COSTA MESA,CA Zip: 92626 Contractor: ALL STAR WATER HEATE C Address: 30300 PUERTO VALLERTA Pho . - MENIFEE Zip: 92584 Lic se: 2894 SCOP OF PERMIT WATER HEAT CHA =OUT E SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0. 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0 0 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $ .00 0 ressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System .00 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher 0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor 00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0. 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.0 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas( er 4 lets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Re pe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Se a $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptor (Gre e, • $0.00 0 REINSPECTION $0.00 0 Interceptors and uto) $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. (tom I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. (\J My workers compensation Ins nee carri r and policy number are: -7 U V Carrier: / f'-7+ 7� C,n c Policy Number: / / ( / G / /D (This section need not be completed if the permit is valued at one hundred dollars($f00)or fess.) ❑ 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 C:•omia,and agree that if I should become subject to the workers'compensation provisions of Sec'on 3700 of e Labor Code,I shall forthwith comply with these pro sion0 ._S Applicant Signature: - Date: 5 WARNING:FAILURE TO SECURE . •RKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUOJECT AN EMPLOYER TO CRIMI PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000 N ADDITION 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 77provisio 5 Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Codq,and my license is in full force and effect.Lic.# / [F !' -' Class# C. 7 b r'-- JContractor's Signature: i-wt/1 Date: ( — S— O 6 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 driver's 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)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title B,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: I 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 materiel? 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 form 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 art RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑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 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? In Yes 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 ❑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 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. "—�3' nature Of LegaOwner(s) / gate_ And/Or Authorized Applicant / l Date CODE 4 INSPECTIOfLIYQE DAIS INTITIAL$ CODE I INSPECTION TYPE PAIL II4IIIALI 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Ro0f 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 1 r rf . CITY OF COSTA MESA � BUILDING DIVISION > %t r,,,raor l" ih. 1 DEVELOPMENT SERVICES DEPARTMENT PERMIT MBER 4.4,111.11411,0* PERMIT 5-02083 oernit V . (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.a.LMLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3100 YELLOWSTONE DR Status: ISSUED Suite: Applied: 11/17/2005 Vicinity: RESIDENCE AND ATTACHED GARAGE Issued: 11/17/2005 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 14107222 Zoning: R1 Applicant: WATSON, KRIS / Address: 2219 W OLIVE AV air SUITE 282 Phone: 888-311-7663 ISSUED BY: Sr ` BURBANK,CA Zip: 91506 Owner: DANIEL, CHARLES E _ . Address 3100 YELLOWSTONE DR Phone: COSTA MESA,CA - Zip: . 92626 , Contractor MODERN ROOFING ' -" Address: 2219 W OLIVE AV . SUITE 282 Phone: 888-311-7663 BURBANK,CA Zip: 91506 License: 807881 Arch : • - Eng: Address: Address: Phone: - Phone: Zip: ., License: - License: • SCOPE OF PERMIT- ' REROOF RESIDENCE AND ATTACHED GARAGE:T/O EXISTING COMP ROOF,REPAIR/REPLACE SHTG AS NEEDED;'1 LAYER 30#FELT,APPLY "30-YEAR COMP SHINGLES."2500 SQ FT 41 - - 't FEE SUMMARY Plan Check: $0.00 Calc Valuation:, $4,000.00 Permit: $97.25 Claim Valuation: -$4,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: • $97.75 • - :PLANNING &ZONING SETBACKS - ' ' MAIN STRUCTURE Front 0-0 .. Rearu,.0=0 Left ,0-0 „' ='Right, 0-0 ACCESSORY , -Front • 0-0 -Rear. ...0-0 _ '- Left ,0=0 -• Right 0-0 PARKINGExisting: 0 Required:.==0 -- - Proposed: 0' - • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-48(8/00) I WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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 Isued. t NI 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 woael's`'�cpLmpensalign Insurance carrier and policy number are: p,[� Carder.:J+-.xz•.Q. -kpha Policy-Numtier.000CtCt V-I-ZOZ (Thislection need not be completed it 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. 'AppflcadtSignature: (pates, /14 7 OS' WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO RIMINAL PENALTIES AND CIVIL FINES UP TO CNE HUNDRED THOUSAND DOLLARE($100.000),IN ADDIRON 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 Professions Code,and my license Is in full force and effect.Lic.Hl 007.a/ DaClass-Ng c3 Contractod :-�=— -s.Signatureter 17/7-03' 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 en 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's 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: O 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 t0 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 end pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 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 en RMPP is presently required,has Section 25534 of the California 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 agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes L]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? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end 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? ❑Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penally 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) Date nd/Or Authorized'Applicant r_Date CODE f INSPECTIONTYPE PATE Rffill9L9 LODE! 15SPECTIONTYPE DATE MALI 1816 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 ; ' Ib CITY OF COSTA MESA 4 BUILDING DIVISION > •ri•.„,' .,�r DEVELOPMENT SERVICES DEPARTMENT PERMI UMBER PERMIT • 05-00871 (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesaAa. MBING PERMIT� 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 3100 YELLOWSTONE DR t L Status: ISSUED Suite No Applied: 11/17/2005 Issued: 11/17/2005 Vicinity: GARAGE Parcel Nunmber: 14107222 Applicant: DANIEL, CHARLES E ISSUED BY: �i/ Address: 3100 YELLOWSTONE DR Phone: 714-556-1564 /`/ COSTA MESA,CA Zip: 92626 Owner: DANIEL, CHARLES E ,. Address 3100 YELLOWSTONE DR Phone: . .COSTA MESA,CA. . _ - Zip: 92626 Contractor:- OWNER-BUILDER • Address: - - _ Phone: ' Zip: License: 000000 ' SCOPE OF PERMIT - . WATER HEATER CHANGE-OUT IN AN EXISTING SFD. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. FEE SUMMARY �" - • • AMT QTY - - . -AMT .QTY . AMT ' ' QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0• Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 .0 , Swimming Pool. $0.00 0 Backflow Preventer $0.00 0 P-Trap . $0.00 0 - - • Trap Primer - $0.00 0 Bathtub - $0.00 0 - Pressure Regulator - -. $0.00 0 : - . Urinal - $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) - $0.00 • 0 ' Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) , $0.00 0 Receptors $0.00 - 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher - $0:00 0 Sewer Cap for Demo $0.00 ' 0 Wash Basin Set $0.00 0 Drain,Floor , $0.00 0 Sewer Connect $0.00 0 Waste and Vent System ' $0.00 0 Drain,Rainwater $0.00 0 - Sewer Private Line • $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00. 0 Shower i - -. $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain . $0.00 0 Sink,bar : $0.00..,,, 0 Water Piping(Ins(or Rep.) $0.00 0 Expansion Tank $0.00 0 ' _ Sink,commercial - $0.00 -..0. .;Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor . . , $0.00 " ,0 - - 'Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen - $000 0 Water Softener $0.00 0 Gas(Over 4 outlets) . $0.00 0 - - Sink,service/mop ' - $0.00 -0-.` OTHER . $0.00 Gas Repipe $0.00 0 . Spa(private) , , $0.00 0 ., •1, .VIOLATION $0.00 Gas Service $0.00 0 ._ Spa(public), , -,, $0.00. ._2 ' ,, PLAN CHECK $0.00 Interceptors(Grease,Oil) $0:00 0 , . ". ' REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00' 0 ' . . , • ' - - •' '" - >?. TOTAL CALCULATED FEES: $35.80 - -i-'-.COMMENTS"!SPECIAL CONDITIONS`';.' • AIttp . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46 WOO) ci3masimmisimmisimmomm. ., . , 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: Cartier: Policy Number: (This section need not be completed ll the permit Is valued of one hundred dollars($100)or less.) T f certifythat in the performance of the work for which thispermit is issued,I shall not employ any p y person in any manner a as to become subject to theI shall f compensation elaws rofo California,od agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these provisions. ` y� 'Applicant Signature-77T:- a�/ (� Date: N 0N1 . VI) ° 0 OS WARNING FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE($l00,000),IN ADOmON 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(commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Uc.a Class 0 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 subjects the applicant toe 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 appty 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.). • G /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 appty 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.exampt nderieec. Business and Professions Code for this reason: kis g ature:'"r l ptsi .r) \Data:--) Nov 1-7, -2 Do c Owner ID verified by driver's license. 0 Yes 0 No Drivefs'Ltcerise Nbs�i - Expires: '7-Ili-2D10 Verification of Ownership by(type of document,I.e.-property tax bill or deed):Us-- -1l 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? 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 form 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 0 No ._ the applicant p present ._..tu-re ._ .h c ___ 5 Does or will oast Air orQualityManagement or n building occupant at require for the work ontch is the nor agency?this application appermit for such constmcilon or modification from the South Coast Air District or from any other air pollution control district or Yes L]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? 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 01 the disclosures prescribed by California Health and Safety Coda Section 42303 been made? 0 Yes 0 No B (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that and 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: 0t4!, x44-• i Date: ,a�,. • - ,ct3 ver `CERTIFICAW!OFjCOMPLIE 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 aglee to cdmply with all state law's and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for ie on purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. c�h d>g/ ply— MeV—I-;7,') 0 0 S Signalize Of.Legal.Owner(s). --'k 1,DateJ And/Or Authorized Applicant Date CODE I INSPECTION TTP$ PATE MILS CODE I [NSPECTION TYPE �, MILn g Rit�Ltl 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 • FEE REpajE[ i359a_• (4- JAN 1 01961 COStA MESA BUILDING-SAFETY DEPARTMENTFINANCE DEPT. P.O.BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA f0R APPLICANT TO flit IN COMPLETELY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS 3100 YELLOWSTONE DRIVE COSTA MESA. CALIFORNIA fOR OffICE USE ONLY I RECEIPT NO. PERMIT NO. OWNER KW CONSTRUCTION Co., INC. 3(� MAIL RECEIVLpD BY DATE RE IVEy I DATEI�� ADDRESS 1555 PLA CENT IA AVENUE !� j— (�/I JHlwj l 1961 TEL. h1I BUILDING CITY NEWPORT BEACH CAL F NO.6-3227 ADDRESS ARCHITECT LIC. OR F-1INEER NO. COSTA MESA, CALIFORNIA FIRE 1/ (�/1 �C d-- STATE ADDn..SS ZONE TYPE ✓ GROUP t--Y 1 CONTRACTOR K. W. KOLL LC.NO.61195 BY DATE DATE ADDRESS 1555 PLA CENT IA NEWPORT1 '�BI+EA CH ZONING ��'I O LEGAL. LOT 21 I I 40k1 ZONE NO.OF USE OF NEW blll&L emu. DESCRIPTION NO. BLOCK TRACT R-1 _ I PLANS 2 BUILDING N/ att Aar A.P.NO. none APPROVED YY 1'� BY W.L.D. '//��E/, DATE i-6-6i OF LOTSIZE 60X100 INOW ory LOTO YARDSVES REQUIRED ALLOWED USE OF (CENTER LINE ST.) EXISTING BLDG. FRONT SIC.FIE. IN. SETBACK LINE FROM 55 I 23 ' CENTER OF STREET REAR YARD R.SIDE FT. IN. 5` 5' SIDE YARD LEFT RIGHT L.SIDE FT. IN. DESCRIPTION OF WORK NEW I X II ALTERATION I II ADDITION REAR 3 FT. IN. REPAJrt I II MOVING I DEMOLISH BUILDING �/ NO.OF SIZE 1506$F ROOMS 7 STORIES' 1 EXTERIOR WAI�� (ROOF COMPOSITION �`� COVERING JTUCCO COVERING SHIw'1 ES D ,/SIG USE OF BUILDING AND WORK TO BE PER ORMED Y SINGLE FAMILY RFSIDFNCE ANn /� ATTACHED GARAGE. PLAN No . 3-A . I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT ND AGR TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINA CES AND LAW GULATING BUILDING CONSTRUC ON. VALUATION SIGNATURE OF 24191 PERMIT FEE $ .3 5: PERMITTEE '/'�/ / / $ PLAN CHECK $ /`'/7 .5-0 21G'/ .9-----AUTHORIZED AGENT /JTOTAL FEE $�7 of PROPOSED PATIO COVER GEOF AND EMILY MACKPRANG 3100 YELLOWSTONE DRIVE - N • -A 4✓ T ' 6 \...`Z1 ): . O\CI J t 30 3 • ' • wwitci 2,91¢ ,-LA-filet c s r 0 ,MA'F C16l51e1r[ 0002014-3 ,/EA.514e A35 �Ioe �,r/ 6 F�s.�A /� aCw L-1c v,11 relit ( - Sea assimul //� 7" 25/0 — 1 i EYISIHJ4 .-----"E sitss AM o /o o • 'X* x \ein0 ista-c4 ,,,,ii vlo NORTH . vlieN � �$: % % o`eco $f it% iak i\‘' I . `A 14 2.514" c : g ¢ StolE t i - 1/j QUALS 1 It q LAPIPRUVED 1 40' L) CITY OF COSTA NIESA PLANNING DIVISION SUBJECT TO BLDG. DEPT REG. NOTE: ADDITIONS, DELETIUNs. OR CORRECTIONS SHALL HE / N . ._. . _ APP' S - . - - . . 1G DIY. BY: `//�. DATE: �I2 09 YELLOWSTONE DRIVE " 4 0 0 pUv