HomeMy WebLinkAbout3154 YELLOWSTONE DR - Building Permits PROJECTADDRESS: 3154 YELLOWSTONE DR UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; M 069383
OWNER'S NAME: ORLAND IE,tt��BEVERLY A TR FLOOD ; X 47
ADDRESS: 3154 YELLOWSTONE DR 92626 PERMIT NO: M 069383 PLAN CHECK NO: N GOVT; N SUPP: N
COCONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH
979-8528
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : FAU CHANGE OUT SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC-VALUE; GROUP OCC; R-3 /
PERMITTEE: A-AMES PLUMBING & HEATING ( 714 ) 530-2440
ADDRESS: 9911 LARSON AV B COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
GARDEN GROVE CA 92642 +E*+E****+r**+r+l*************dr***+E*+r+r****+Eyr+E*******TE****dE*+r*****+E+F*+6*******+E***+r**+6
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQU IR EMENTS
7000)of Dive o P t usiness and Profe i.ns C.deand my lice in full force and eff' SETBACKS
(�BiG�� + 0+7 C-36 :Xr : 06/95
CITY LIC.: STATE LIC.:
j r _ — MAIN BUILDING ACCESSORY BUILDING
Date: l /1R��Y sigFRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that)have a certificate of consent to self-insure.r a certificate o orkers' LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
Compensation 13190t3t2 Lcttified copy thereof(Section 3800, Lab.0.3/01 /95
POLICY NO.: REPUBLIC EXP.DATE: PARKING REQ: PROV; PARCEL; 14153113 ZNE; REF NO:
COMPANY: ��(( PLANNING NOTES>
❑ CertifiedIcopy is hereby furnished. LT Corti •d copy' filed with Building Division. >
ld 1 « I el �c 11-- �. - *******D*E*V*E*L*O*P*M*E*N*T***S*E*R*V*I*C*E*S***R*E*Q*U*I*R*E*M*E*N*T*S*******
Date: Applies
7 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed lithe permit i5 for hundred($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 ZONING APPROVED BY
subject to the Workers'Compensation Laws of California. •• DATE:
Date: Signature: BUILDING APPROVED BY ; •
NOTICE:It,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE;
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED BY; 11 r Q
CONSTRUCTION
rm LENDING AGENCY: I7.hereby Civ.affirm that there isaconsbuction lending agency for the performance of the work for ********************************************* ********************* * *-** **
which this permit is issued(Section 31197.Civ.C). ***********************************************.***********************{*+********
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'Slate License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM I P/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 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 25% SM I P/NON-RES
pursuant to the provisions of the Contractors'Stale 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 ISSUEFEE 1 5 . 00
•
any applicant for a permit subjects me applicant to a civil penalty of not more than live hundred dollars($500). BUILD I NG-D I V-> PERMIT ISSUE PLAN-CHECK TOTA PAID DUE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 9 . 00 15 ,00 0 . 00 24 , 24 . 00 . 00
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Coder The Contractors'State License Law
doesorherapplywtoeap owner propertypfathat who buildsmrve improvescs ot ndd whodoessuch alerk. I,howleverthe orthroughor REVENUE DIVISION TOTALS--> COLLECTED: 24 , 00 OVER/SHORT: . 00
his fown an ene,provided y such improvements are not n,intended oro does for sale. (( 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 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
for the purpose of sale). 24 . 00
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ***,*.*.****.***„************************ik******************************************
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. IND I VID UAL • F EE BREAKDOWN
❑ fexempt under Section: B.&P.C. TYPE QTY DESCR IP T I O N • UNIT COST TOTAL COST
forr this reason:
Date: Owner: MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 .00 9 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505, I 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.
eri
Date'. Applicant:
I hereby certify that I have read this application ands t the above information is correct.I agro.• .comply with all city an (runty �" �xrry
ordinances and state laws relating to building constructs •reby authorize ep'sentatives of this Ily to e 'r upon the above-m n Toned 9• 00169875 TOT 24.00
property for inspection purposes. • O3 U036.375-
q /� � DATE: :DI14I94 TINE: 14:14
Date'D.j�' f c '1 Signal re. - A _
Driver's License or Social Security n:
1641-46 White—Budding:Green-Code Enforcement;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor
V
CONSTRUCTION AND PLANNING POOL .;PA
APPROVALS Permit# Date Inspector APPROVALS Permit ,"+` Date Inspector
1. Temporary Electrical Ser Jice•pr Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. __ 53. Steel Reinforcement
-
"'T3:"c'ect•ical Cond tt4JtilityEtJndrgrnd : - 54. Forms -
-,^,. 1 c, -,�4..
.q._ . ,, - - - y
.41 �1ectstcal Corid tt•Yndrgrnd.-- 55. Electrical Bonding
"'-58Steel Reinforcerrmeot 56. Rough Plumbing & Pressure Test r.,
t''i -4r1 , - , _. m.
y •
-, 6:Electrical UFERr.nd. ' . 57. APPROVAL TO COVER-GUNITE
.. _ _..-' -id.
;I::74cFbotings �'r - \ -- 58. Electrical Conduit-Undrgrnd. t '-+
; 8;Foundation .` „ 59. Gas Pipe, 0 Undrgrnd-, Test -
1>9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, 0 Undrgrnd. t='
•
;y TO' Structural Flo;r System 61. APPROVAL TO DECK
. ,operty Sewer Line & House Connection 62. Backwash & Receptor-Final
,-
12. Sewer Cap - _ - 63. Heater & Vent-Final
11:8. Roof Drains C 64. Plumbing System - Final
'1:4. Rough Plumbing _. 65. Electrical-Final
t.5. Rough Electri.6a!-Conduit_. • 66. Solar System-Final
F6. Rough ElectricWiring 67. Fencing & Access Approval
1.7. Rough Wiring Sign `` 68, APPROVED FOR PLASTERING
a.
18. Rough Electrical-7 Bar Ceiling 69, POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
T ..i r' -• -.
20=.Rapgh'Factory ioeplace i x - �•-1 ; 0 D ^* * r1APP130V ,7,..1 ",
b$C Q Pe7fnit # * •'• 7.1
21`Dints,i Sti+ct6;� ;; -Hi j * . 41 70. 3Jndergrgti, J Hsdro `n
22. Ducts,&entilatihT• i S ,;; i , os 71. Produ t R;fling E:,as 0Oil
23=Gas�Pip Roy h& lest ' * ` T 1
. 9 'rt_. • r c 0 a. * 72. Undergfotirid F�,IEus1i
24:r Roof Framing �/_ s : Q r t 4 ••:• 73:; Undergrrid Sto a!Tankt0 Gas 0Oil
25. Rodf Sheathing;-_ v , ,= p3, t. 74'? Overhead Hydro
t
26-T-B r Ceiling (Structural) & M_onocoat s f' to _i pi A +.k 75.' Dry Chemical ' _ H =' -
JI-
27:-.'Frame and Has i to -t . rr }i?_ n' `,'
ra, hP9 .n r 76: Dry Stargt�e � M
' !28'.' Lathing"& Siding"' -.a -t•-. + a 5 ••* , 777'' FIXED �S'(STEr1-FINAC` it
"29. Insulation .-• ' " y `T! j ; * 78 FIRE PREV. FIN4L ,, a• i
30. Drywalj�lailing u I i e r146ALTHiDEPT.iREQ1/411REMENT
'31. PlasterBtown Caat ° 1 �'` 79•0 FINAL INSN PECTIO -
.4 I I ,s .. t-,.. .-
:-32v Electrical Power'-Metpj-Finay v I I* * ,.180x,FOOD CERTIFSMTE ISSUED
33,Fi I Electrlt B i I - r" ," ' '
... og L •. m - I I _ (` 4 • ' Notes: ..1 -1c'7 , .1 O
-, 34:,Find Heating&.Qtc Oondition�n9 - id )t >< ta- u _C7" Ci,r. :�'-
�35:nFidai Gas Pipe-Test • _t ! 1* ., Ck ms • T Cr .
.- x 1 I 14 , ,'J «o pt-i:-. 1 '.,,
.36^Hood or Canopvo , , •, - n I I• v :- -L• C:O t r rEr. . re TO ,.
'-37• Final Factory Fir Lade I = _' `• n'1Y"- -./ - C' * -'x
T' t -r-- - ...
.38. Final Plumbing - • ,,1 i . s vI: , -._._
;--1 s :n
i--
539.
^39. Water Service-Final 1 w a I ' it * • riot: 0 :.lm . C:
• rr, Vf 1 iii 4 .a .. * to
:r40. Gas Service-Final i rt r •,1 a e ,;r _,
y /
:=41. Solar Domestic-Finals •• * Os I I * f < r-a
�- - t, ♦ -) -I _ -- `---
42'Backflow Prevente4 I i r _ -
43. Backflow litigation - _ L . - i:XH a 0 a•
s o. G L Cl •
4 r S S t
:_44. Landscape irrigation System-.,t - n, rl i; J
E ; - a: c-a 7.,;(--a0a •:.t
_ r D
r - - <- -.
-;45.:Sound Attenuation ^i-r * <- E-• H i~ t . -1 *i -1 c•-2. n C t
- .. . z o. ty is t r ,-1 . r_. , *
,'46:;Handicap Regulatipns • D I'' : i K L• a t ' ■
•.47. FlhtAL STRUCTURE & BULLDING 4 1 ) It
48.'FINALPLANNING , ir • i j• . , . II ti z..-
c49._Electric Release to`Edison * , r_- i - l -• l a hi
'50-Gas Release to Southern CalifdGnie Gas Co . I I - I, # L � Cl . otn ;i .4)
51. CERTIFICATE OF OCCUPANCY • , z .
No. Date
'P••Sif•b nUNE, eu,aratci t:. Lf'' 4...4-.00
JOB ADDRESS 3154 Yellowstone Drive BUILDING PERMIT NO. 25543
GENERAL CONTRACTOR Owner-Builder DESCRIPTION OF WORK Repair Slab
AP No, 141-531-1 3 LOT TRACT FIRE ZONE VALUE $ ppp,OO
I' 'ECTIONS
Signature Date GROUP I TYPE
III ZONE R-1
S ( PERMITS ISSUED
Gas SUBCONTRACTOR Date I Number I Signature
Water Plumbing
Rough Plumbing _
Prop. Swr. Line:0 House Con. p
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning
Temporary Service or Pole
Underground 0 Power 0
Rough Wiring �/ / Heating and Vent.
Trenches,� Forms ❑ Steel Reinf.Er c' . 7i rep
�
Floor System }; x/,644 t � .71. l,� 7- 6x6 X/oY/O
Bond Beam 0 Steel Reinforce 0 :/J
Sheathing
Frame and Flashing
Lathing—In❑ Out 0
Plaster, Brown Coat
Stz,,tura1, Final Electric
H+ '�'�rsg, Vent., Refrig. and AC., Final
Pl ftbing, Final and Gas Test 0
Electric, Final
Building, Final---'- 17.=:b 04 // y'
25543 CITY O\ FC3STAMES
A
COSTA MESA BUILDING-SAFETY DEPARTMENT
p.0. BOX 1200 COSTA MESA, CALIFORNIA 92626 - APR 5 1966
For Applicant to Fill In Completely APPLICATIO PE
$
TYPE OR PRINT 3 -LUNDhrE •
§ r,: ( . -
ADoRlue 3/.5'/ Y�L.ZevyS%1A/ .PR.
RECEIPT NO. PERMIT NO.
COSTA MESA. CALIFORNIA
di r p7- nay . REC NIDD ///���IDA 4.71,7i,,,,,;,
OWNER di o/=/� / C. /-7704./ r `JI/ T/ (////O I.CJ
MAIL, q BUILDING�� L /! �� / CF �1
ADDRESS D/i f$2 t ec Al .g;.-
FIRE
/ ADDRESS J S� L
n�/ FIRE ��
CITY.4A/V%A /Yd'ISI. NOL�I.nV/Z ZONE TYPE GROUP //��
ARCHITECT TEL --
BTPROV¢D DATE-I I (!J(S
OR ENGINEER NO.
zO G
ADDRESS
�ry��) �/� �p/�I7 / NO.OF USE OFNEW' I
coONTRAOTo IJ n 'air ('f�I I PLANS ( ) BUILDING�j �-7�
ADDRESS UESCCILIIPTION /t'J (v 3(�'�'-(C/3"]1) °
A.P.NO. (L7 / ^.1 3/- �( 3 .
CITY /
NOTE: NO SAVE OVERHANG SHALL BE LESS THAN
STATE TEL SO•TO SIDE A REAR P.L
LIC.NO. NO.
EAVES
SIZE /- NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT)
OF LOY 7Cco -S4 • F! . I HOW ON LOT
USE OF C YARDS APPROVED YARDS APPROVED
�O114 C MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG. f
'---4'''' (FROM C/L STREET)
SETBACK LINE FROM FRONT FT.
cENTER OP STREET REAR YARD
snag YAK)I LEFT RIGHT R.SIDE PT, FT.
DESCRIPTION OF WORK L.SIDE FT. Fr,
a
NEW ALTERATION ADDITION REAR FT. RT.
\ DISTANCE BET. BET.MAIN a
REPAIR X,_MOVING DEMOLISH MAIN BLDG'. ACCESS.SLOGS.
BUILDING NO.OF VAR.* / DATE
SIZE /4?2*i G^. I%, ROOMS STORIES / C.V.P.* APPROVED
EXTERIOR WALL I ROOF �-r APPROVED217
[�,_(`r6
COVERING TVCC/; COVERING J/4L%/4 LF SY (A --11��.. AT[ ( 7
USE OP BUILDING AND WORK TO BE PERFORMED /} "Y 0.
/Vn497 - V w
(Z/Yn '/7/f/ SQ.Fr.
I HEREBY ACKNOWLEDGE TNAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE C.
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDI AND STATE LAWS REGULATING VALUATION
BUILDING CONSTRUCTION.
,//��I / O
SIGNATURE OF/'I 07A17-76.4 /??CLAT/1 / PERMIT FEB s (� E
SIGNATURE
f 8 i001) PLAN CHECK S w•
AUTHORIZED AGENT
1 TOTAL PEE f 6
OWNER fimjNr l0HN C� _ DATE 1-30-62
JOB ADDRESS 315)! Yellowstone Drive BUILDING PERMIT NO. 16265
GENERAL CONTRACTOR owner/builder VALUES 230.00
AP No. LOT 3 TRACT 3500 FIRE ZONE DESCRIPTION OF WORK blockwall
INSPECTIONS Si !
gnature DATE GROUP TYPE ZONE R3-
SUBCONTRACTOR
ISSUED
SUBCON
G..a DATE NUMBER
Water
Rough Com. Refrig. 0 Air Cond. 0
Rough Heating
Rough Plumbing
Miscellaneous
Prop.Swr.Line 0 House Con. ❑ St.Swr. ❑ _
Sprinkling System
Cr-notion Pole P.
Underground 0 Power ❑
Rough Wiring Jto
Trenches Er Forms 0 Steel Rein m(0344- 1_
Floor System _
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing — In 0 Out 0
Plaster, brown coat
,s g. ❑ Air on . ❑ ma
I°'z',ng. Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final Row- x—L0- 0-
OCCUPANCY
FORM BU4-5M - 7.61 16265
1626 FFV RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 3 01962
P. O. sox 317 COSTA MESA. CALIFORNIA FINANCE DEPT: ,
For Applicant to Fill In Completely APPLICATIWITJ1'Fe&GG FACT IE"A
TYPE OR PRINT
BUILDING_ ( yj _ _ BUILDING.
ADDRESS 3/Jy /ELL LY/)_no Ai Zk 1lit
logy
MESA.( ,gCALIFORNIA For
rOffice Use Only •
OWNER l�fy C 6(J JJJ RECEIPT NO. I/ PERMIT T N3-
MAIL f,/ ,/c _ ]�
RECEIVED
DV DATE RECEIVED {I (D/GATE ISSUED ,
ADDRESS 3_6 /Ca.00w S/ ow U/t f/ {(/) - &75 IIS ��I �- ^��
CITY eon-4- 4165 4 NO.ki 7/GJ' 1 BUILDING g/37/ADDRESSz / i% 1 %
ARCHITECT TEL. COSTA ME CALIFORNIA
OR ENGINEER NO.
ADDRESS FIRE
ZONE TYPE
CONTRACTOR c:–/ F-- APPROVED
/�A^ BY DATE
ADDRESS S /y( C ZONING
z°7---(
ONEn /I NO.OF > USE OF NEW g16G116 n/
CITY a �1 I PLANE L I BUILDING 4-ii
STATE NO. LEGAL Let3 %Q 3 rn
LIC. DESCRIPTION
SIZE I NO. OF BLOCS.
OF LOT NOW ON LOT / A.P.NO.
USE OF %L�- )�E%✓et: YARDS EVES
EXISTING BLDG APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT FT. .-_____ IN.
SIDE YARD I LEFT I RIGHT R.SIDE d FT. —J IN.
DESCRIPTION OF WORK —
L.SIDE FT. IN.
✓/
NEW II ALTERATION I II ADDITION I REAR FT. IN.
MOVING I DEMOLISH I APPROVED G n�� DATE //Jo%.I-
REPAIR 5 /
BUILDING NO. OF
SIZE ROOMS STORIES
EXTERIOR WALL 1 ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
6113Y /O' roof it UcK i� / X /ot'' X 6 a &7t411,.
WALL E tTIOni l (o /geH6 77lic
I HEREBY ACKNOWLEDGE THAT I HAVE -RAD THIS APPLICATIO THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE I+ OR; A A EE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINA E= AN' - A RE LATINO
BUILDING CONSTRUCTION. VALUATION B.Q
SIGNATURE OF PERMIT FEE $
PERMITTEF , L a
S43o PLAN CHECK $( 1 q6
AUTHORIZED AGENT f F
E
TOTAL FEE $
Lot? 3 Tr 3500
+,. .. 14462 ,FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT ) MAY 171951
P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
For Applicant to Fill In Completely F&Th KNIII A MESA
PP P Y APPLICATION E I
TYPE OR PRINT BUILDING
BUILDINGR3154 Yellowstone Drive
COSTA MESA. CALIFORNIA For Office Use Only
RECEIPT NO. E yT.ay
OWNER IC W IC Construction Co. . Inc. I 1�q`4 10,4
MAIL
RECEIVED BVDATE RECEIVED DATE ISSUED
ADDRESS 1555PLA CENT IA AV F (4 I ,5-/�4/ I 4-/0-41
CITY NEWPORT BEACH NOMI 6-322 BUILDING
ADDRESS
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER NO. \\\
ADDRESS FIRE 1/ �//� .*//- r
ZONE TYPE 1. GROUP l�.9 / `nJ
CONTRACTOR K.W. KOLL APPROVED
BY DATE
ADDRESS 1555 PLA CENT IA AVE . ZONING �,�'1
ZONE NO.OF I USE OP NEWaingi fain.
CITY • NEWPORT BEACH / R-1 I PLAN2 BUILD!Haw/ att gar.
STATE TEL.LIC.NO. 61 [95 NO. IMI 6-3227 ESCRIPTOH int 3, Tract 3500
OP J-/ // // ///^�`.J NO. OP BLDGB. 3
OF LOT (J/D• �/1 J -I NOW oN LOT A.P.NO. none
USE OF YARDS EVES
EXISTING-BLDG, NQNF_ q(.' APPROVED ALLOWED
SETBACK UNE FROM _ ✓0 / REAR YARD cel / FRONT
LINE ST-> �--y FT. IN.
CENTER OF STREET v J _
�. I �.i CC
FT. IN.
SIDE YARDI LEFT RIGHT R.SIDE �l
DESCRIPTION OF WORK
L.SIDE FT. IN.
NEW I Y II ALTERATION I V ADDITION I REAR 3 FT. IN. '
REPAIR I II MOVING I VDEMOLISH I APBYPROVEDId. L. D. DATE 5-16-61
BUILDING NO. OF
SIZE 1342sq ftROOMS 6 STORIES rlb
EXTERIOR
WA�JTU cc() I COVERINGppd shingle j _`3 9a J
USE OF BUILDING AND WORK TO BE PERFORMED /� �g/
c IMO1 F ELM.LI V PSCInFAlrC' &MD
ATTATCHED GARAGE
Plan No_ 1-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•
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION
SIGNATURE OF , (/ PERMIT FEE S
PERMITTEE M �-� -7,-7
-
S 7�_`er—`- �J[9j' PLAN CHECK S / i
AUTHORIZED AGENT 7 /'� f i
TOTAL FEE •i I — I
OWNER aimmi, ligailRCr. DATE _2_6Qq
JOB ADDRESS 3154 Yellowstone BUILDING PERMIT�IO. 19197
GENERAL CONTRACTOR Bay's Fence Co. VALUE $ 570.00
AP No. 141-531-13 LOT TRACT FIRE ZONE DESCRIPTION OF WORK blockwall
INSPECTIONS Signature DATE GROUP J TYPE III ZONE Al
ISSUED
Gas 1 SUBCONTRACTOR DATERWIITSNUMBER
Water
Rough Corn. Rettig. 0 Air Cond. 0
Rough Heating
Rough Plumbing
Miscellaneous _
Prop.Swr.Line ❑ House Con. 0 St.Swr. 0
Sprinkling System
Construction Pole
Underground ❑ Power Li-
Rough
Rough Wiring
Trenches Forms 0 Steel Reinf>gl ft'fkU, .4C-34(
Floor System
Bond Beam 0 Steel Reinforce 0
Sheathing
Frame and Flashing
Lathing — In 0 Out 0
Plaster, brown coat
?
0 Air Cond. ❑ Final
1'iOng, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final
OCCUPANCY
FORM ROM.SM - 1-61
•. 19197
FEE RECEIVED
r COSTA MESA BUILDING-SAFETY DEPARTMENT MAR P.O.BOX 917 COSTA MESA,CALIFORNIA MAR ?'-7?:�1rr9gg63
FINANCEs�Itld�N�
For Applicant to Fill In Completely �� ICF4T �FpRMfT
TYPE OR PRINT UU
/ For Office Use Only
BUILDING 31 Sry *Oa%)` ,
ADDRESS '�/ i
RECEIPT NO. Y MI O
COSTA MES CALIFORNIA J.�_ J JVY
(/1 RECPe&Y DATEpECEIV A IBsu
OW Q14hi. C0isN (y/,M,/)f7j- 3�//�'/7 4 L> I 63.
MAIL 31C4 yuleADDRESS 3/,5'¢ Yez/zoLr/t 'ON,Z
ADDRESS W CK� / i eZe3C/
PLEAS ZO E TO L K 14 L�`
CITY I► O NO. - ZONE TYPE OROU
APPROVED 3l 7 N`
ARCHITECT TEL. �. BY DATE
OR ENGINEER NO. 1 -
ZONING we
ADDRESS ZONE NO.OP USEOF NEW
Q R_1 I PLANE a I EUILOINO ..ca
CONTRACTOR` 17, F,VC � a 1 1 T �R-C'(
ADDRESS '\ O�rZ� -`� i�.(� • DESCRIPTION Z,/Oi-3 / 3 J � '
CITY IV Cs�Rf�st�i� A.P.NO. . / / — ."'i 3 J - 13
6TATE TEL `_ NONOT TO SODA V ROVE HAVE OVERHANG SHALL BE LESS THAN
LIC.NO. IZ ll .CS NO. 3a 1-fc7
EAVES
SIZE S-6,(G x _/VI, 2A NO.OP BLOCS. ALLOWED (U.B.C.REQUIREMENT)
OF LOTNOW ON LOT
USE OF YARDS APPROVED YARDS APPROVED
EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING
' (FROM C/L STREET)
SETBACK LINE FROM FRONT FT. FT.
CENTER OF STREET REAR YARD
SIDE YARD I LEFT )1i I RIGHT S
R.SIDE Fr. FT.
DESCRIPTION OF WORK L.sloe Fr. i FT.—
X
f
NEW ALTERATION _ ADDITION age
REAR FT.3 — FT.
DISTANCE BET. BET.MAIN Q
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
BUILDING NO.OF
VAR.# _� DATE
SIZE ROOMS STORIES C.U.P.# /(j APPROVED
EXTERIOR WALL I ROOF COVERING BYPROV/A�.4 .O'/J��L DATE 447/`�
� COVERING ✓I
USE OF BUILDING AND WORK TO BE PERFORMED
CI &AM ' gal
in 1(/69 .F, BO.FT. el
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THA : ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL ITT .-O NANO AND TATE WS REGULATING VALUATION ....... 0
BUILDING CONS :UCTI•
CCP PERMIT FEE $ 5 n
SIGNATURE -- . ' m
PERMITTEF Y taw MM el Ea
>< ci,12 PLAN CHECK $ ell
AUTHORIZED AGENT Od c
a. A TOTAL FEE $