HomeMy WebLinkAbout3119 YELLOWSTONE DR - Building Permits PROJECT ADDRESS: 3119 YELLOWSTONE DR 0NIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 053781
OWNER'S NAME: HOFFMAN, RICHARD _•
ADDRESS: HOFFMAN LORI • x•;/ • PERMIT NO: M 053781 PLAN CHECK NO: N GOVT: N SUPP: N
3119 YELLOWSTONE DR
COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5-N PERMIT TYPE: MEC PURPOSE: OTH
ARCHIENGINEER: REG.NO.:
JOB DESCRIPTION : NEW HEATING & AIR ( INCLUDES GAS SYSTEM) SQFT:
ADDRESS: UNIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
PERMITTEE: AIR PLUS ( 714 )662-5894
ADDRESS: 1372 VALENCIA AV COMMENTS: RE: E53780 MISC. ELEC. PERMIT FOR H&A
TUSTIN CA 92680 �E�P*+E***********************�r�E �EkriIEEE****************EE******SE*************TE*******
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)al Division 3 of the Business and Professions Code.and my license is in full force and effect. S E T B A C K S
CITY LIC.: 054115 STATE LIC.: 618862 CLASS: C-20
Date:-9'/-C2-=9/ Iherebm: .� tto iw� MAIN BRIADING ACCESSORY EUILDING
WORKERS'COMPENSATION DECLARATION: thereby affirm that I have a certificate of consent to self re ora enificat orkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3500.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY ND.: 306-9 0 UN I T 0 2 5 0 4 EXP.DATE: 11/01 /91
COMPANY: STATE FUND PARKING REQ: PROV: PARCEL: 14107302 ZNE: REF NO:
D Certified copy is hereby furnished. ER Certified copy is filed with the city Budding Division. PLANNING NOTES>
p >
Date:-I -IC- 9/ Applicant: ************************iE******************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for a honer ($100)or less). DEVELOPMENT S E R. V I C E S REQUIREMENTS
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner o as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY _
DATE:
Date: Signature:
NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. �/
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: r /``` DATE: �O P�
which this permit is issued(Section 3097,Civ.CI ******.**.**.*******.*,**,*,**** ** 1***( ** *******************�i�9FB irs t***
LENDER: ********************************* ****** * **********************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 21 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed X,
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 70110)of Division 3 of the Business L 5 Y SM IP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15. 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 21 . 00 15. 00 0. 00 36.00 36. 00 . 00
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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 36 . 00 OVER/SHORT: 00
for purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 36. 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ***,*.******,***.********,**************,***********************.*****.**.****_***_*****.**
that proof of their Worker's Compensation insurance should be provided to me,
amo I exempt under Section: B.&P.C. I N D I V I D U A L F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: owner. MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00
Ido hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9 . 00 9 . 00
25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from MEC 1 GAS PIPING SYS 1 - 4 OUTLETS 3 . 00 3. 00
these provisions. END OF FEES
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspection purposes.
Date:9?•Lp g/ Signature:..
Driver's License or Social Security a: 01 &EC y i i _
1.:772: CS 'il'.1 m:." ,. :'• . .
1641.46 White—Building:Green—Code Enforcement Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL 'A
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Serviee or Pole •� 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement
`4P•• IQFt€ical Condyielkility-Undfgrnc&t" ; • 54. Forms '�••
c.4;jEleeaical Conduit Undrgrhd. ,u 55. Electrical Bonding
?
PROJECT ADDRESS: 3119 YELLOWSTONE DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 053780
OWNER'S NAME: HOFFMAN, RICHARD
ADDRESS: HOFFMAN LORI Al PERMIT NO: E 053780 PLAN CHECK NO; N GOVT: N SUPP: N
3119 YELLOWSTONE DR �f
COSTA MESA,CA 92626. CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW HEATING & AIR (MISC. ELEC. ) SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE: AIR PLUS ( 714 ) 662-5894
ADDRESS: 1372 VALENCIA AV COMMENTS: *
TUSTIN CA 92680 *************************************+E*****************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R E Q U I R /E M E N T S
7000)0l Division 3 of the Business and Professions Code.and my license is in lull force and effect.• SETBACKS ----.N_______„.CITY LIC.: 054x �1,15 `STATE ELIC.:618862 CUSS: C-20
/— Daml_9e/�.C�JQ/ Ihereb a ✓ ---) '1.i��J MAII BRIADING ACCESSORY EAILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent m s I4insur or a cer c e of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copythereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICYND.: 306-90UNIT2504 EXP.DATE: 11 /01 /91
COMPANY: STATE FUND PARKING REQ: PROV: PARCEL: 14107302 ZNE: REF NO:
❑ Certified copy is hereby furnished. x Certified copy is bled with the city Building Division. PLANNING NVTES>
q�0r 77 >
Date: Applicant: - /� � .�/ *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the pe :t is for r e hum.r WOO)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the pertormance of the work for which this permit is issued.I shall not employ any person in any mann i/'o as to become
subject to the Workers'Compensation Laws of California. .,\ ZONING APPROVED BY .
DATE:
Date: Signature:
NOTICE:11.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: � DATE• 27/0
which this permit is issued(Section 3097.Civ.C). ******,***************** *** S Vin******************* — •. . . . . . . *,*
LENDER: *****i6**'*.****** ******************** *** ************************************
ADDRESS: LEGALIZATION;N . F E ,E'': SU MARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: Ihere0y affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 15. 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 50 2 SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/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 do0ars($500). ISSUE FEE —15. 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLANCHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 15. 00 15 , 00 , 0. 00 30. 00 30 . 00 . 00
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 em0loyees,provided that such improvements are not intended or offered for sate.II,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 30. 00 OVER/SHORT: . 00
improvement
olsae)
sold within one year of completion.the owner vnll have the burden of proving he/she did not build or improve
torthe purpose BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI TOT GRADING PLAN=CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 30. 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon •
and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law),I am aware ********************************************************* *********************
that prool of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.Si P.C.
torthis reason: TYPE QTY D E S C R I P T ,I 0 N UNIT COST TOTAL COST
Date: Owner: ELE 2 MOTOR/POWR APPARATUS 1 . 1 — 10.0 HP . 50 15. 00 7
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES '
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
( .
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from .
these provisions.
Date:_- Applicant: .
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all city and county
oulinanceS and stale laws relating to budding construction and hereby authorize representatives of this dty to enter upon the above-mentioned
property for inspection purposes.rp ///((( �I
Date:_o t� 7/ Signator ' _ 77
/ _ ✓ A�l t
—' Drriver's License or Social Security x: / 1 - - :. - •
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor — - - - -
•
CONSTRUCTION AND PLANNING POOL PA
APPROVALS Permit# _ Date Inspector APPROVALS Permit # _ Date Inspector
1. Temporary Electrical ServiEe or Pole 52. Pool & Equipment Location �'
2. Soil Pipe-Undrgrnd. •-• zt t - 53. Steel Reinforcement
'-q,,tElecrical Conduit•UUility-Uridrgrnd7,-`- ', 54. Forms l-
(1 4;xEledtrical Conduit Undrgrnd. Sr 55. Electrical Bonding
'3.'$teel Reinforce ent - 56.. Rough Plumbing & Pressure Test LC
to _ n •
u6` .Ftec&rica1 LIFER Grnd. '4 57. APPROVAL TO COVER-GUNITE
s'T:7 ootings •.= ' 58. Electrical Conduit-Undrgrnd. 4 W
ot Foundation .r A h )
59. Gas Pipe, 0 Undrgrnd., Test
.n 9. Water I j
Pi a-Undr nd.
P 1 l 60. Backwash Lines, P-Trap, O Undrgrnd.
C70. S[uctural Floor System ,-i 61. APPROVAL TO DECK ;-?
11. Property Sewer Line-& Hoossetonnection 4 62. Backwash & Receptor-Final i
,r r 1 ,
12. Sewer Cap ' 0 63. Heater & Vent-Final /
a. C V i t,•
13. f Drains r ' w1 64. Plumbing System - Final J.
14. Rough Plumbin ., !r
g C: 65. Electrical-Final
15. Rough Electrics]-Conduit r .i"' 66. Solar System-Final + /
16. Rough ElectricWiring ;?1 A� 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.nRou h F ctory Fireplace i �.,,n S~ ^ r w, s
Win• tr.:/' r � R'IIq 1' d^S -, h ♦ �
21. Duc}s,in StructuZR, -•• „ O1-T..: 1:,. 70- Unda7ljrgcra1't`C,Hylro -
A + - x ,' r• .. . - -.LC T
22. Ducts, Venti)ating s S v S u:* a •c71. ProductrP ling I]:Gas O:Oil
23.-„Gas Pipe`-Rough& Test r a ., ` ` -.1.72. Under ounyy Flush; .* C'
,S > s Q :max �• g ` Y .,,
24.:Poo1 Framing. - k . • ,3 r x ». .7& Undergrndt StorageTank.0 Gas 0 Gil
y'
25. Roof Shia' s11.1 > I. t" :: :tilet :1
r '.� ,., C Ol* 74.,-.Overhead7-lYdro-
26-T-Bar Ceiling (Structural) &-Monocoat * - w r, tn; -:. 75.. Dry Chemical '''...:?.1. r 1 r
27rFrame and Flashin 'r• " W' -R Y- 76t-Dry Stan pipe 5' * S' ,11 -
2 e . ;is.tC Y rxx -�
itn,� h: rx 3, d '* _ to
•_28.''Latf;ing Siding -.( t -t it t •• ••i ••x x 77rr FIXED SYS'TEM.F:INAL^ .--
'29. Insulation C '- " 5 (n 4, " 74
FIRE PREV. FI �l} *
:-30. DrywalltNailing t x � t!.,1[::. :r HEALTHrDEPT,REQUIREMENT
•r
=31. Plaster Bfowo Coat` I �ir II ; ' r. 79�FINAL If�I$P„ECTIbN? * c C Z.32.=Electrical Power MeterFinali ' p) ) y7^. 0- OOD CERIIFIE�i IS6UEDD /ftK //
�33�Fi al E(ectris t", Q :i9a ,P ' 'Notes: /....,9-592_,:540Q__ ` �J
:34.�Findl Heating& O,i yConditionmg, �' I 'c, "r� ^J•.. t � ^'.-. "'�
•�
- 35-Final Ga'�Pipe-Testi ' n i. ' .I hi,'..c :s ' " ., on tc.5 a. r O
,i36.4Hood of`CanoPY : '-, I •r ;I,•,•,'"x .,r. > •�•r
_37.CFind1 Factory Fireplace , ' S`y •-• x :n , 'I e .. >. " c • In
> '.0 A. CJ
"38. Final Pl4m9 * x * u)
bin * S ' • r - -
I _ I . x S
.:39. Water Service-Final+ ' - :r I j: a - C' •.:to * 4J'
r pi
v40. Gas Service-Final " "
,r1 'r ti v,cti .r ,> . 111 - lr % r0 0n.1 ? .,
741. Solar Domestic-Finals - •• it •? - lax *SO i- a
42.=8ackflow Preventers ti ,r, � i rrr. ,-, C- x
I P x s.
43. Backf low Irration• ut .r. > . UCi-a I. C t-
„ - tt; x i I •
�c . .XA -• N * :‘U ! .t .- •ti
;44. Landscape Iti;igation System loci .y ,. .n L" x x co ,q EJ o
'45 CSound Atterivatiort' -+'r:l- >: l:a r ^ 1-4 a•c is -1 r
,. t .. i in h1 tris X - cr 7 wi ' . .. t
?46 Handicap:Regulatio's ,_ "
47.-FINAL STRIsCTURE & BUI.DING s I I Ci- �- 7 of :S
n •I' I + '-- I / t C :t -
48.tNALPLANNINO + ;rt; i ;Ih ' 0o'n -a
r
.;-49. Electric Release to!Edison , .. ; i/its.. F i>; I - y
-
.:50.SGas Release to Southern California Gas Co j I r * OC , a r•:
•
_51. CERTIFICATE OF;OCCUPANCY v ;, Mcg
No. Date -
r
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 1 43E 7/:7/.1' .- :
•
C
.3 PERMIT NO. TRACT NO. LOT NO: UNIT NO.
ITv OF COSTA1E A D (N�STR CTION M a9/9(o
f,
Project Address IJ 11 �`, 11W I VtTh
Applicant's Mailing Address 5 TYPE OF CONSTRUCTION LJ NEW L I ADD LJ ALTERATION LJ REPAIR
•
• • FSA 1� 1 UP'?
111 CONVERSION ID DEMOLISH LI OTHER A.p.# Zone
Owner's N ��� :''1� 7 7 -� 2 d`:. •Tf64f6 IOUY _}//' DESCRIPTION OF WORK/USE OF BLDG.
Address -�1 '�r�-. ' S Main Building: Accessory Building: Z
E
Arch/Eng. • License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front O
Address - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear N
Contractor's Name /\ Phone (7 -
{F`.l\1 OTHER
PROJECT DESCRIPTION SQ. F3K - ` (PS OCCUP V C Right N
Address(mailing) rC� K
G
CONSTRUCTION TYPE VALUATION�( /V IyJtJ'� $ Left R
City License No. ZONE GRADING CU.YDS. /ACRES
LICENSED CONTRACTOR CLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: QM
with section 7000) of Division 3 of the Business and Professions Code,and _ • T
my license is in full force and effect.
License Class License No. -. S
Date Signature
PLUMBING FEES
WORKERS' COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
;00, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
ACertified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs • Sewer Connection Cooking Unit • Meter ❑Up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • _ Dishwasher Meter Clover 100 amps
(This section need not be completed if the permit is for one hundred($100) or
-
less). Dishwasher Solar Piping _ _ Dryers OGas DElectric 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 ma er so . o become sy bject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1%-8
Workers' C• 1• sation Laws of Califo ni \ -
Date 21 U - Signature •f 'rhf Floor Drains Swimming Pool w/Spa F.A.U. Ino Solar ❑9-15 HP 016-15+
NOTIC :If, . er making this tleclaratie sho Id b me subject to the -.- - - — -
Workers' Compensation provisions of the Labor Code, •u must forthwith Floor Sinks - Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performancePole Light
' of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets
Lender's Name Range
Lender's Address Kitchen Sink Water Service
•
OWNER BUILDER DECLARATION Switches Sign
I hereby affirm that I'am exempt from the Contractor's License Law for the Lavatories • Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW Trash Compactor '
any structure, prior to its issuance, also requires the applicant for such permit P
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 i '
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 •
—
nalty of not more than five hundred dollars($500). I
as owner of the property or 'ry pl y •i•^- ago:06 "hof—sets Reinspection Fee $15 Issue Fee $ 3
will do the work, and the structure is not i'•ntended 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). • •
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 7—/3 O�(7
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 • SUMr1$Q�V OOF�FEES
builds or improves thereon, and who contracts for such projects with a con- p(..// ((�,
tractor(s) license pursuant to the Contractor's License Law). I am aware that . Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ vc
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT -
❑ 1 am exempt under Section B.& P.C.f•r this reason Firepl/Fact.Blt. ICBO# Fire Dampers - - ISSUANCE $
1 1 ' PLUMBING $
Date 9 i.l°4I - • Owner ' dte ori-,is .', 4 J Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
�..
I hereby erti y hat I have read t s '.pplication and - ate h.t he above ❑o-100,000 BTU 0100,000 BTU '
ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city ..•d county ordinances
and state laws relating to ilding constructi•n,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
•
sentatives of ibis city t•t, ter upon the hove-mentioned rop for
inspection .ur..ses. ,r ) A I,I MECHANICAL $ TOTAL FEE $ a7rS0
Signature 1I'' , Ap Data
Drivers' Li coo•r SS of /I1'
CMF 0865.46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
•
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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, C) Undrgrnd.,Test
9. Water Pipe-Undrgrnd. .- • 60. Backwash Lines,P-Trap, O 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 ❑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 PREY. 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 3411 •$?it
48. Special Requirements Completed
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY. t
No. Date - '
13543 FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT DEC 291960
P.O.BOX 317 COSTA MESA. CALIFORNIA `FINANCE DEPT.
SA
FOR APPLICANT TO FILL IN COMPLETELY APPLICATIdN FORaPE MEIT
TYPE OR PRINT BUILDING
BUILDING
ADDRESS 3119 YELLOWSTONE DRIVE
COSTA MESA, CALIFORNIA MR OFF/CE USE ONLY
• RECEIPT NO. ,,���++,,yy
OWNER KWK CONSTRUCTION In. . INC_ I1 �3J4!1
MAIL RECT�I jO.,BY O T RECEIVED. DATE ISSUED
ADDRESS 1555 PLA CENT IA AVENUE �_ EflD Y I 1 1r;ko DEC.)
J vu
TEL. BUILDING
CITY NEWPORT BEACH CALIF ND.6-3zz7 ADDRESS
ARCHITECT LIG.
OR 'INEERICNO. COSTA MESA. CALIFORNIA
FIRE1./ _///��1��'
ADDRESS ZONE TYPE GROUP4?
STATE APPROVED (/
CONTRACTOR K. W. KOLL LIC.NO. 611 BY DATE � �����/I
ADDRESS 1 PLA CENT IA NEWPORT 1 1BEA CH ZONING
LEGAL LOT 4ok1 ZON(k NO.OF USE OF NE
DESCRIPTION NO. NF1 BLOCK TRACT `I� -- I I PLANS I BUILDING ! cI A
APPROVED
i1\I !11 W J
A.P.NO. :17
1 /. DAME 1,. ...)._//_,6
�- —Ip
SIZE 6GX1GD NNO.OF OW ON LOTS L)),E+ •✓
OF LOTO YARDS ES
REQUIRED . ALLOWED
USE OF (CENTER LINE ST.)�uI. � (
EXISTING BLDG. FRONT t k FT. - "K�]
j) 344.
SETBACK LINE FROM 1 I U 1111
CENTER OF STREET 5 REAR YARD 10 R.SIDE C FT. IN.
I I
SIDE YARD !LEFT 5 RIGHT 5 L.SIDE FT. IN.
DESCRIPTION OF WORK ?
REAR 3-3 FT. /o IN.
NEV I X II ALTERATION I II ADDITION I
REPAIR I II MOVING I II DEMOLISH I
S ZIE NROOMS LDING 14D7SF 6 STORIES 1
EXTERIOR WALy1, ROOF COMPOS IT ION
COVERING JTUCCO COVERING SHINGLES
USE OF BUILDING AND WORK TO BE PERFORMED
SINGLE FAMILY RES I ONE CF ANn
ATTACHED GARAGE PLAN No. 2-DR
I 'HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES AND STAT AWS R GULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUCTION. I VALUATION
SIGNATURE OF /tl�� � �/� PERMIT FEE S /L/�
PERM TE /, /5,/,
,J 7/ 717
$ {/ / /�/ /� PLAN CHECK $ /
AUTHORIZED AGENT TOTAL FEE $ IS,.
ana
L.\
•
27808 Inv -9-67pc1:,:„.00*u 37C
COSTA MESA BUI ING-SAFELY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92620
For Applicant to Fill In Complotoly APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
[uILnINa y/ For Officio U» Only
ADDRESS .3//y. /E'«mLUs70,C/e
RECEIPT NO. va P(RMa N .
COSTA MESA, CALIFORNIA // 7C1(/ t((/
�'J/ ///
try 7...111177 ./DATB I sup
OWNER / / .0. zC/AsT /� ovOl/ /W_.
MAIL � ADDRESS BUILDING 3/i7 g� �a/srei•(//E^
ADDRESS //yP/'G/�
TEL. ZONE TYP GROUP
CITY NO.
ARCHITECT ///J TEL. APPROVED 7
:: E GINEHR Ci Allir �,n.S N•: / DATE/7.-- �`
ZONIN
At"
REED a?, " e.c S>ewer" _ r�,,,
ZONE NO.O/---'SII ...OF NEW
I - / PLANS "1/*- I BUILDING
rviril
CONTRAGTGR7N1.5��oic/f� !/ oe.L S 11 /, I /
ADDRESS Sf7/ /�/� �Q�r DESCRIPTION 441 ! 4/ / fir vai(,
CITY (/T 7.e— A.P.NO. /111' U 1 3 - o /-
NOTE; NO EAVE STATE �j �J TEL SO•TO SIDE B REARRHANG SHALL BE LESS THAN
LIC.NO//&7 EAVES
SIZE /f /ANO. �07�"� e—
OF LOT E1 O C . O o I NOW ON LOT ALLOWED (U.B.C.REQUIREMENT)
USE OP J///' /^ �J YARDS APPROVED YARDS APPROVED
EXISTING BLDG. Lr.1 4'' �, ,e.e MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET) 1
SETBACK LINE FROM / / " / FRONT PT. I/l FT. (9
CEN1U OP STREET /O/ ` REAR YARD / c
al
EIDE YARDI LEFT / • I AS / R.SID _J J FT•it
RIGHT '
DESCRIPTION OF WORK L SIDE FT. 67 FT.4
ALTEHRATION ADDITION REAR PT. FT.
DISTANCE BQT. BET.MAIN&
REPAIR MOVING _ DEMOLISH MAIN BLDOS. ACCESS.SLOGS.
BUILDING I'//561 NO.OP VAR.* DATE
SIZE ROOMS STORIES C.LI.P.# APPROVED �l/�
EXTERIOR WALL I ROOF APPROVED (A2/1 I/- �7-O /
COVERING COVERING ST SATE d
USE OF BUILDING AND WORK Br PERFORMED / IL
LI)_f_(1R SPECIAL REO UIREM ENTS m
Vac.e....77:71
7 et
EO.PT.
I HERESY ACKNO 11401kTMAT.11 HAVE READ THIS PPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 9
AND ETATS THA HE ABOVE IS CORRECT AND E TO CAM. PURPOSE OP ESTABLISHING A PERMIT PEE ONLY.
PLY WITH ALL ITY ORDINANCES AND STATE OULATINO VALUATION
BUILDING CO -/ = /a`���QJ// PERMIT FEE n[
5 ! ,^I -
SIGNATURE •
PERMITTEE Aro
E
PS /J /� PLAN CHECK S (J — w°
AUTHORIZED AGENT , C/ I�rit.Z41-gal /
/ , TOTAL FEE S /�-'
DATE
WEST, M. W. 11-8-67
.4 JOB ADDRESS 3119 Yellowstone Drive BUILDING PERMIT NO. 27808
GENERAL CONTRACTOR Anthony Pools DESCRIPTION of WORK Private Swim Pool
/ 10. 141-073-02 LOT 41 TRACT 4041 FIRE ZONE VALUE $ 2,400.00
\I. ECTIONS Signature Date GROUP ,T TYPE TTTTf ZONE R-1
SOIL I PERMITS ISSUED
GAS - _-- --- SUBCONTRACTOR
Date Number I Signature
WATER �/ Plumbiiy
ROUGH PLUMBING IA ',SL/ a 4 it-ft-6;�g'7(
PROP. SWR. LINE ❑ HOUSE CON. ❑ .X��w ///.3.i, p`7O_ff
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING c+.__, Heating and Vent.
TRENCHES ❑ FORMS ❑ STEEL REINF. ❑
FLOOR SYSTEM j A ��
BOND BEAM ❑ STEEL REINFORCE ❑ , fj i (lin{p —�^`e��„'_,
SHEATHING �r. ..14 R1
FRAME AND FLASHING S ' °
1 .ti - �r r � r1
LATHING — IN ❑ OUT ❑ f F er — � '°
PLASTER, BROWN COAT f `y,° 4 7
Cy,II N fir”
S" TURAL, FINAL ! ‘"Ele%tri
HL AG, VENT., REFRIG. AND A,C., FINAL g ���+ :IP ( ,lir', • -/_��
PLUMBING, FINAL AND GAS TEST EllIGf (nnvu IIID;Alp, .',";. y
ELECTRIC, FINAL -�s`'�-+.n..-�Prry :
BUILDING, FINAL