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Home My WebLink About3118 YELLOWSTONE DR - Building Permits 5111 CITY OF COSTA MESA . BUILDING DIVISION ). , ti DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT y. P 4 0550 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 3118 YELLOWSTONE DR Status: ISSUED Suite No Applied: 08/06/2004 Issued: 08/06/2004 Vicinity: Parcel Nunmber: 14107225 • ISSUED BY: Applicant: SZABO, KEVIN Address: 17390 MT CLIFFWOOD Phone: (714)241-1414 FOUNTAIN VALLEY Zip: 92708 , Owner: BULLER, DALE R TR Address 3118 YELLOWSTONE DR Phone: COSTA MESA,CA Zip: 92626 Contractor: COAST ROOTER PLUMBING HTG &NC Address: 17390 MT CLIFFWOOD Phone: (714)241-1414 FOUNTAIN VALLEY Zip: 92708 License: 529127 Arch / Eng : Address: Phone: Zip: License: SCOPE OF PERMIT WATER HEATER CHANGE OUT. -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 $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 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) 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 ❑ e for which this permit is issued. erik 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 if the permit is valued at one hundred dollars($100)or less.) YI certify that in the performance the work for which this permit Is issued,I shall not employ any person in any manner so as to be me subject to the workers' compensation law of alifoml nd agree that If I should become subject to the workers'compensation provisions of Section 3 of the bor Code,I shall forthwith comply with these r isions. O —//" Applicant Signature: Date: WARNING:FAILURE TO SECURE ORKE 'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND ML RNES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE,INTEREST,AND ATORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am!icons under visi ns of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code .nd my license is in full force and effect.Lic.# Class# Contractors Signature: Date: 4f.IAkair • 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: 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(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 properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 6,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 Califomia 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 Califomla 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 Safely 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 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 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 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 ins tion purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. yuraOf Legal Owner(s) Dat Sii "----Nit.'" d/Or Authorized Applicant D to o/ CODE t INSPECTION TYPE PATE INTITIAL6 CODE If jfSPECTION TYPE PAM INIIIIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical i 1 u,L, � 1266 Pool Spa Final 208 Final Plumbing C O'-170,4 kita-,\ 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 Sign222 Final Site 204 Final Demolition 250 Final Building/Occupancy 13591 E1 RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 1 01031 R 0.BOX 317 COSTA MESA.CALIFORNIA FINANCE DEPT. yO ' EAFOR APPLICANT TO FL /N COMPLETELY APPLICATIONFRroue. TYPE OR PRINT BUILDING BUILDING 3118 YELLOWSTONE DRIVE ADDRESS COSTA MESA. CALIFORNIA fOR Off/CE USE ONLY O. OWNER KWK CONSTRUCTION Co ., INC . I RECEIPT NO. ^ �yHV MAIL RECEI ED BY DATE REC IVEO '1l DATE ISSUED ADDRESS 1555 PLA CENT I A AVENUE �— /,C.- I / �4 - / I 'Jr.:, 1 1 Ms TEL. BUILDING CITY NEWPORT BEACH, CA LI FNO.6-3227 ADDRESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA FIRE // ADL .S ZONE TYPE GROUP'"? CONTRACTOR K K. W. Ko /LL LIC.STANTE O. 61 195 APPROVEDBY DATE ADDRESS 1555 PLA CEN'LI A NEWPOR T11 BEACH ZONING p.� ��$ 4041 ZONE NO.OF USE OF NEW 01p1451 1� DESCRIPTION I NO. N.AFJ 18 I BLOCK I TRACT R-1 'PLANS 2 I BUILDING-/ att pal . APPROVED..L.D. DATE 1-6-61 A.P.NO. none BY WW SIZE 60X100 I NO.OF BLDGS. YARDS EVES OF LOT NOW ON LOT 0 REQUIRED ALLOWED USE OF (CENTER LINE ST.) n EXISTING BLDG. 3016" FRONT Sd FT. IN. SETBACK LINE FROM CENTER OF STREET REAR YARD 5oI R.SIDE C/FT. IN. ( SIDE YARD LEFT 51 I RIGHT 51 L.SIDE // FT. IN. DESCRIPTION OF WORK REAR4 9 o FT. IN. NEW I X II ALTERATION I II ADDITION I R EPA I II MOVING I II DEMOLISH I BUILDING NO.OF SIZE 14075F ROOMS 6 STORIES 1 EXTERIOR WA-y,,11.. ROOF COMPOSITIONIT ,�TT COVERING JTUCCO COVERING SHINGLES 6 0�`N USE OF BUILDING AND WORK TO SE PERFORMED SINGLE FAMILY RESIDENCE AND ATTACHED GARAGE. PLAN No . 2-C � I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM PLY WITH ALL CITY ORDINANCES AND STATE LAW EGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRU TION. 4. VALUATION -P /.--- PER SIGNATURE OF / y 7G7 PERMIT FEE $ PERMITTEE / '7 $ _ PLAN CHECK $ �^/ AUTHORIZED AGENT TOTAL FEE S v� f "•~ 41 148 itI" 29-76—,F,�?OO1o53'a *****g.5O COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 jaPL ATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only _ REC I ED DATE RECEIVED DATEAS U BUILDING J G $t ADDRESS -31fP /E�oL�S�/'rQ �r�Iy/� TJX 1/q^ J(IN�p' OWNER 'DSO-E P• �ULf_T A.P. NO./�/'—V �.wC—c , 1 PE .` /F MAIL ll// BUILDING 1 (� ADDRESS 3 / 17 T6LCAWs, o „1/L I)? ADDRES$i�'aNeIOUIS /1 be. TRACT4 1 LOT /5 BLOCK CITU COl..-vr.)tf'�-Iq NJ�s� NO. 97//-Or� qqq ppp CONSTRUCTION NEW ALTER REPAIR MOVING; DFMDI ISH LENDER _BRANCH OWNER LJ✓ALt�r R�lil.L(� ADDRESS ARCHITECT TEL. fvc -j 1377o C AL4 OR ENGINEER NO. �/�$— FIRE 3 ADDRESS ZONE TYPE _:SEGROUP ,,,///}}} .l)nl Zit/ !� t APPROVED �/ lel/ e7/L ONTRAGTOR t � � BV /Y/-- DATE (/ ADDRESS NO.OFn CITY NOL ZO iOFfifiW (PLANS OSI USE BUILDIN • 6a3_/per-��,yY'�I_ F STATE CITY YARDS\\\ APPROVED YARDS APPROVEDf g LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING'L SIZE NO.OF BLOCS. (FROM C/LST SET) L M. OF LOTIQ I NOW ON LOT FRONT A SIFT/ FT. a USE OF �� 4 EXISTING BLDG. R.SIDE C. FT. rn �/� FSeparate permits are required for L.SIDE LI IFT. FT. • electric,plumbing and heating work. 0 REAR FT. FT. W USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLOCS. ACCESS. BLOCS. ..1I II y 2 ( /Ir VAR.# DATE Q 737-to/� Covet_ ll /t I d ^b C.U.P. 1b A /�//t j/ APPROVED f Cea/ a LOS-D _flAPPROVED/lithe ROVED/,�, /Lt /DATE /aZ��D C4 / N w o I hereby acknowledge that I have read this application and state n n <Y that the apove information Is correct and agree to comply with m a 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. 02/0 I hereby certify that I am properly licensed as a contractor under SO. FT.02/0c ii State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ e and Professi ns Code,Division 3,Chapter 9. ''// n ./^//�D^ PLAN CHECK $ / e Signatur , fF Jt t' o Permittee aNN��CCC $ TAX $ 2 O Authorized Agent TOTAL PAID $ t5TJ ,OWNER BULLER. Dale R. DATE 1-29-76 '. JOB ADDRESS 3118 Yellowstone Drive BUILDING PERMIT NO. 41148 GENERAL CONTRACTOR ' Owner/RIr1r DESCRIPTION of WORK Screened at Io Lover A INSr'Ei.CTIONS 141-072-25 LOT TRACT FIRE ZONE Signature Date VALUES 800.00 GR 3" OUP , ZONE R—I SOIL1 so TYPE V PESMITS ISSL ED GAS SUBCONTRACTOR I DateNumber Signature WATER Plumbing ROUGH PLUMBING tisviPROP. SWR. LINE 0HOUSE CON. SPRINKLING SYSTEM ISC EL LAN EO US ROUGH HEATING AND AIR CONDITIONING . TEMPORARY SERVILE OR POLE UNDERGROUND ❑ POWER 0 ROUGH WIRING Hearin, and Vent. TRENCHES FORMS STEEL REINF, FLOOR SYSTEM��-T BOND BEAM I I STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n t-�OUT I t PL'H" R. BROWN COAT SW z. SyS ;,=.'URAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n 1 ELECTRIC, FINAL BUILDING, FINAL ,//a 14t7k