HomeMy WebLinkAbout152 YORKTOWN LN - Building Permits p F 9 • CITY OF COSTA MESA •
BUILDING DIVISION
s • �.;,. ,� DEVELOPMENT SERVICES DEPARTMENT ERMIT NUMBER
PERMIT
r, ay /B02-01198
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.c6UILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 152 YORKTOWN LN Status: ISSUED
Suite: Applied: 08/01/2002
Vicinity: 152-160 YORKTOWN LN Issued: 08/01/2002
Parcel Number: TPN98078 Zoning:
Applicant: BLANKS, JERRY ISSUED BY: n
Address: 17501 NORWOOD PARK PL
Phone: (714)573-0155
TUSTIN,CA ' . Zip: 92780
Owner: MONTICELLO COMMUNITY ASSOC.
Address 150 VALLEY FORGE
Phone:
COSTA MESA,CA Zip: 92626
Contractor: PREMIER ROOFING AND BUILDING CO INC
Address: 17501 NORWOOD PARK PL
Phone: (714)573-0155
TUSTIN,CA
Zip: 92780 License: 634404
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF BLDG WITH ADDRESSES 152-160 YORKTOWN LN FOR"MONTICELLO HOA":T/O FLAT ROOF ONLY, INSTALL 1
BASE,4 PLY AND ROCK WITH HOT ASPHALT.4800 SQ FT
• FEE SUMMARY
Plan Check: $0.00Calc Valuation: $14,100.00
Permit: $251.25 Claim Valuation: $14,100.00
SMIP Res: $1.41
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $252.66
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
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
244646(6/00)
DECLARATIONS cs ' v
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.
t ) 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 work s'compensation Ipaurance carrierrand policy number are:
=carrier. �r/±./77? /-1'-/V// ed'icy_Number: 7* g/57 0/
(This section need not be completed it the permit is valued et one hundred dollars($100)or less.)
O I certify that in the part• ance of the work for hich this permit is issued.I shall not employ any person in any manner so as to become subject to the workers'
compensation laws o alifornia, .nd roe t III should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these••i • 7/VC),"
A IBate:- U
x �O
WARNING:FAILURE TO S-•'WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI ALP NALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DCLLARE(S1.8,0031•IN ADDITION 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 underpryrov cions• Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effec c._P��G' 0 ,, Date: r. G—.
Contractors Signature: rr _ Date:-.1 wL
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.).
O 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.).
❑ 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 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 WIII 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 tiled 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 greeter 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? ❑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 Califomia 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? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No
(Section 65850.2 of the California Govemment 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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Sign r f al Owner(s) �// n
And/Or Auth ze-fid Applicant ' Date
IDete-
CODE I INSPECTION TYPE P.M 1NTITIALS CODE I INSPECTIONTYPE DAM REAL$
• 1618 Fixed System Final Fire Prevention _ 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing .
200 Final Re-Roof 8.—/57-192-.— 4/'Le" 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
ADDRESS OF MALLOW: 152 YORKTOWN LN WIT: CITY OF COSTA MESA - BUILDING PERMIT
warn NuIEIFlwwm: BIEL, RICHARD K PERM NO: B 073484
t . ADORESS 2303 POPLAR LN
COLLEYVILLE, TX 76034 PERMIT NO: B 073484 PLAN CHECK NO: N GOVT: N SUPP : N
•
Mak.WILING ADDRESS: CONSTRUCTION TYPE; VN PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: Lx.NO. JOB DESCRIPTION : T/OFF, SHEATH 6 REROOF W/COMP SHINGLES SQ FT: 2, 999
ARCH.OR END:S ADDRESS: WIT:
CLAIM VALUE: 2, 999 .00 CALC-VALUE: 2, 999 .00 GROUP OCC: R-3 /
mNmscion9Ner. STOUT ROOFING INC ( 310 ) 923-6775
cannACTOws MAILING P 0 BOX 4309 COMMENTS : SMOKE DETECTORS ARE REQUIRED PER 91 UBC
ADDRESS: DOWNEY CA uc.ND_ 402536 *********************+A****it**Ar*AEit*+t+EAE****x•***Ar*Ar*+E************* *Ft*AE*aE•**+E+E+EAr*it*
90241 UMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Nam under penal rjury that I em licensed under pr., . . of Chapter S SETBACKS
(commencing with Section 7000)of Division 3 of the and Prof ode,end m Ikons Is In lull • - .effect.
CITY LIC.NO.: 059377 7 LIS 39 uc. . 02 6 E 10 ' 5 MAIN BUILDING ACCESSORY BUILDING
1 /� , . ' RNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
ods: c«aaa« LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
/ OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I em exempt from the Contractors Lew for the
following reason(Section7031.5 Busiessend ProfessionsCode:Any city«county wnirh requires a permit tocanehud,aley Improve, PARKING RE PROV: PARCEL: 41916523 ZNE: REF NO: •
'.mdih,«rape)any apuduro,prior n as Sauenra,aso regwrae the lica
appnt for each Perna to De a signed statement that ha rah* PLANNING N TES>
icensed pursuant to the provisions of the Contractors license Law(Chapter 9(commencing with Section 7000)of Division 3 of the .
sinew and Profenione Code]or that hear she is exempt therefrom and the basis tor the alleged exemption.Any violation of Section
/031.5 by any applicant lar apermnsubjects theepprcern to adebpen°Dy of not snore than rwe hundred dollars(S5001). *******************************************************************************
❑ I.aaownerofthepmPedy«myeiroblwwfhwagesastheieolemmprmYon,waldoDwwakandtwmuctun'and'wended DEVELOPIAENT SERVICES R E Q U I R E M E N T S
«Need for sale(Section 7044,Business and Professions Code:The Contractors License Law does nal spell to an owner of properly
who builds or inproves thereon,end who does such work fined or herself or dry he or her own employees,provided that such
improvements are not intended or offered for sale.IL however.the building or improvement is sold within ane year of completion,the ZONING APPROVED BY DATE:
owner-builder wA have the burden d proving he or the did ofd bud or improve for the purpose of cab).
❑ I.aacans'athemaasnT.'an°sa.eyoanna"9w'1'r«„°dad,oaddana« tid the aciaal(Sedbn"44.ethane"and BUILDING APPROVED BY : DATE:
or
Professs Code:The LicenseContractors Law doe* ato an owner of poppy Po beide a improves thereon and mw. �'
contracts for such projects with a mntrerg«(s)licensed pursuant to the Contract=License Law).
❑ lamexempt aroersedian: B.AP.C.,Ice this reason: 'APPLICATION ISSUED BY: DATE:
********************************** * *************************** IS
Dale: o« " LEGALIZATION:N FEE MMARY STRUCTURAL SEGMENT: Y
I do hereby certify that I am aware of and undetwand the requirements of Catania Health end Safety Code Section.25505,25533.and
25534.and that io any haus bulking occupant will 1 wit nor(circle one)need to cows*web end state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
appeerm conshectenon
modiicationfromtheAi age ant acidResidential District. „ re
ionappicati« ° exemptfromthese PERMIT 54 . 00
. 50
Date: Applicant: SMIP/NON-RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ILANE FEE
❑ Ihave and wilm°ntaioecend'odeammentloselinsunfor workers'wmpecantbon,asprovided for byection
Section of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
ode,for the pad .n
dmaeof N.wok tor which Nmass
this Per .uea. TOTALS----> 54 . 50 0 . 00 0. 00 54 . 50 54 . 50 .00
I have end wit maintain workers'compensation insurance,as required by Section 3700 of Ihe Labor Code.for the performance of the
work for which this pen*eissued.Myworkers'pppR rNgpneune ceurtbrewpdry umbo are: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 . 50 OVER/SHORT: . 00
Carver: J 1111 G
Policy Number. 04494u0004687 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
,his section need not be completed I the permit is for one hundred dollars(Stall or less.) 54 . 00 . 50
❑ 1 candy that in the performance of the work for which this permit e' I shag nd employ any person in en annex ea as to
become subject to the worker.'mmpersation ta of Gagonr& pun should become to the
..• penalion. .u. M SsYI00. Cade.I ,. L�;�mW%eAh D-o�se " N��
g
re' ***************************************************************
****************
i7 . i INDIVIDUAL F E E BREAKDOWN"/ / -Date: Applicant: ..leTYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
eming:/Y9ure to manure worker° compensation coverage Is unbwheend shall stablest an employer to criminal p Ides and
civil fines up to one honeM thousand dollen 0100,000A"aAgcbn to the cost of compensation,dentin a.Provided ion In
Section 3706 of MeL.eborCode,lnterest,andattomey'.laa SFR 2999 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 999 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penally Of perjury that there is a conastnidion tending agency for the END OF FEES
performance of the work for which this peons s issued(Section 3097,CM.C).
LENDER'S NAME
LENDER'S ADDRESS:
I certify that I have read this apiarratiort and stale that the above information is correct.I epee to cons*with N city and tarnyordi ansa
and slate bon relating to buiMip construction and hereby authorize representatives of this city to enter upon the above-mentioned properly
fix inspection purposes. .LENE BURFORD
Namedirr ' i'i y. 1-/--',1-757
��• / 01 00?572.0-00187121 TOT 4,50
Signature doewyA9enw.. r. �rm« i
DATE: 07/28/97 TI4E: 59:07
15151-46.WP) White-Building A Safety:Green-Fle:Canary-Appicant;Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL PA ` '
APPROVALS Permit# I Date Inspector APPROVALS Permit # Date Inspector
•
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
-- •Electrical CondU_Plity-Undr <
grnd. 54. Forms
u$, on
^ 4:'Electrical Conduct-Unrgrnd. 55. Electrical Bonding r
: •tr5rgteel Reinforcerpept 56. Rough Plumbing & Pressure Test
c
::'$ 'Electrical UFER-�rnd. 57. APPROVAL TO COVER-GUNITE
•
-''ST' Footings S 58. Electrical Con[ttii Undrgrnd.
C- T. . ,
EC:Poundation 1- W 59. Gas Pipe, O Uodcgrnd.,Test _
9. Water Pipe'Undt grid.' 60. Backwash Lines,FETrap, CI Undrgrnd.
v
10. Structural Floor System61. APPROVAL TO BECK
r a
11. Property Sewer Line,. Housconnection 62. Backwash & Receftor-Fina) •
12. 'Sewer Cap 63. Heater & Vent-Final -
13. Roof Drains ie, . 64. Plumbing System - Final
14. Rough Plumbing. -n 65. Electrical-Final
•
15. Rough Electricaf.Cottluit ,i. 66. Solar System-Finpl
16. Rough Electric' irinj 67. Fencing & Access-Approval
T
17. Rough Wiring Sign i 68. APPROVED FI,Fr'PLASTERING
18. Rough ElectricatT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning _ FIRE pEPT iEOUTAEMENT
-. x In .. .rr.4 ti
20. •F3ouih Fgtor= Fi�tjlace 5:,: tc< * S , i APPiOV,:. ; Pc-limit#
- < - r�
21. Ouctt, irf�tra-ture.` •• •• `-�E z = t7 "li _ 70.'�l'lnderirbu�td f-dro
r c. is,
22. Quct; VCntilg.in&;. C=` .c V < ;', �� < 71. Produel Piping as th Gil
,-.... It ,
23. Zeas R+pe.&ottO, & Test _ t '7 .7 < 3 - - 72. Undergrounde$P
Ftu - * E-•
24. oof=Fra ing" f _ Q. _ _* 7Z Undergrnd.Stgiaye lanky-D Gas ❑Oil
L -
25. Roof-Sheathing -s:t - y.e % O � 74:overhead Hydric T
26. rr-Bac:Ceiling (Strp$cPral) & Irc`nr3coat 4. > 71
m# 76�,LGry Chemical :S� r
27. rarpe and Fleshing* -;;: * > a Y 76. Dry Sta doipe'-.G _
_ r tc n
-. 28. Lathing Siting5*. '- -sem S, T •' 7777 FIXED:2tSTE1INAt__, -
29. Insulation • ?'1* 5 r • ' 7$ FIRE PREV. FIN7\L : > - •
C. _ __.. -- -
30. Drywall Mailing a' - j. S -HEALTH DEP '.'RECUIELEMENT
', 31. Plaster Bro.wn-Coat* S - - a •
• a 79. FINAL WSPEC -MON t
"i - . . --„-L____, * - c- T
32. lectricaFPovygr lt:er-Final • x 7 T, 802 FOOD CERTIP.feATE ISLE¢ _
33. Eini:;Elecric> 7.---; -_ < t* tithes. .T, .C ,.:.:•'.a 34. _Fina£HeStin '& AT!Conditioning' rr. h n - -
^ 35. & Gfinal a&ipsf ,. c
STe . - .. r. I - 20 -- �,-
c - - . - -.
•
'£ 36. Hoob or Canopy x k = "- e- * i t . -
x ,. gc A
1 37. 'F.inai.Faciory Fireplace z Fr- _ i
1 38. Fina(=Plumbing pk ••• ' - ik _ S -• w -
'') 39. Water t
Secvice•Final', .- : y " �y"' x '"' C.
z • Cr
w; 40. Gas Service-Final - ' <` ' " .n tz_'"'
_ _ a '.
y 41. Solar Doinest7lt-Fina: S - °' " C
a r �o c x =
42. BackflovhPreventer+• r- -- 4 x >^ • r -'
Y -- k - rn C.1. .
k r
43. Backflow Irri5tion t j.'- ' x * 17. C ` -• -
R7. .-
r44. Landscapes la:Illatio System?••,• K * :7 G - i 2' * - 5: -
is. Q E F •
45. •found Attendationt, n in t* ', 7 C - E-C
46. Handicap-Regulations =-- x = •S 10 s *
47. IN L STRl1CTUR & BUILDING (/*-(1-:q S kiw c- *
48. FINAL PLANNING! - r
T .. x It i 't . r . c- .
"49. Tlectric Release to Ellison 1 "` - :
Y •r.
a d-• -
50. Sas Release to Southern CalifocniaGasCo * ' - `+ 7_• Orr, - C
•51. CERTIFICATE OF OCCUPANCY S - Cl t c. -
s - .F iJ -. �; ' r
No Date
A 27791 NOV 13-67P°„ 00
' 535R�****90.00
' -
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 9252E
For Applicant to Fill )n Completely APPLICATION FOR PERMIT Np
TYPE OR PRINT BUILDING - b,..1
ADDa (th_t. �Ap for OHico Use Only
RES
RECEIPT NO. 21,7nrro.
COSTA MESA. CALIFORNIA J �/ ((Ll��.
RICE R DATE tCE1VED �OUTi1 EA 7
OWNER San Vista Bldg. Co. �- /I;z2 7 V�• 2�.. D �I�J{O�
MAIL BUILDING
ADESS 2249 Wanderer Drive ADDRESS
DRyyy
FIRE / (/'
CITY San Pedro NCLB33-3320 ZONE TYPE .7/ aRouP
APPROVED
AR CHITEC
ER Clif Olsten 7j 923-122 BY DATE
.._.,REED 90254 E. Florence, Downey ZONING A
;O �j/ I PTA
IANS 1 SUI OF N �nlf S^
'IV/IGGGI al NO.O US O N ` ael
CONTRACTOR Same yry /
LEGAL L� ' J,O • 1 /t�..-/Y- S wo
ADDRESS Same DESCRIPTION /`LLF�(/3'� /� 111"�C�L.HH
CITY Same A.P.NO. / Y�t 7 V 73
STATE TEL. 30'
NO SAVE OVERHANG SHALL BE LESS THAN
80'TO SIDE a REAR P.L
LIC.NO. NO.
/� EAVES
OF LOT OCf).�.�� I NOW ON LOT
ALLOWED (U.B.C.REQUIREMENT/
UBE9P _ YARDS APPROVED YARDS APPROVED
EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING
(FROM C//'L�STREET)
SETBACK LINE IRON mom' / / FT. PT.
aunt R /
OETREAT RAREYARD /�
9100---"YAR LEFT RIGHT �.SIDR I� FT, FT.
DESCRIPTION OF WORK L SIDE 0 FT. PT.
(� �
�/LL.TERATION) ADDITION REAR v Pi. FT. W
DISTANCE BET. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. _
BUILDING��11 ✓ 7., NO OR �1 .� VAR.# c-1-
DATE {./, /x�.! a
SIZE of n M1 ROOMS P STORIES C.V.P.# , /X-'Y' APPROVED V- V U3'
EXTERIOR WALL n ROOF AFFRO 1
COVERING n i tP.A r COVERIt+ r� • eY �I` DATE r 3 0 v11-1
USE OF BUILD!
�y6"B ANTRK TO BE PE ORMED W ..7
( 3) Cu.]
'/�) � a, D.
I ( 37✓ EQ.FT tiler? A
I HEREBY ACKNOWLEDGE TMAT.I HAVE READ THIS APPLICATION c THE AMOUNT• !UNDER VALUATION IS FOR THE g Ce
AND STATE THAT TNI A-• .IS CORRECT AND AGREE TO COM. _ PURPOSE OP E•TABLIEHINO A PERMIT FEE ONLY. Q
PLY WITH ALL CITY 0. •1 AND STATE LAWS REOULATINO A U..
BUILDINGCONSTRU N.
` VALUATION p
SIGNATURE
IRNMITTU EOF `- _ o ail vV PERMIT FEE $ 6 o E A
Er— ? s /Q //I PLAN CHECK S .3 / w t
AUTHORIZED AGENT J Q
.... , .+. . . ;.._.. TOTAL FEE ; / P i
"OWNER mum, VEpN DATE 9-12-68
JOB ADDRESS 152 Yorktown Lane BUILDING PERMIT NO. 29114
'GEN'CRAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Patio Cover
M 141-701-03 LOT 185 TRACT 5160 FIRE ZONE VALUE $ 128.00
INSPECTIONS Signature Date GROUP J TYPE V ZONE R-3
1.SOIL
SUBCONTRACTOR PERMITS ISSUED
_GAS Date Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. El
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER ❑
ROUGH WIRING Heating and Vent.
TRENCHES El FORMS fl STEEL REINF.
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE in
SHEATHING
FRAME AND FLASHING
LATHING - IN in OUT n
P 'ER, BROWN COAT
S_ .TUBAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n .
ELECTRIC, FINAL //
BUILDING, FINAL p [, C
f, ' f 291 14 SEP 12-68E6 343 0*****3.00
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92020 -
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT • BUILDING
For Office Use Only
BUILDING
ADDRESS 152 Yorktown Lane
RECEIPT NO. P RMIT N
COSTA MESA. CALIFORNIA /
REC�E�yES�D�Er ATE RECEIVE.... ��wwTE 1 9u¢
OWNER Vern C. Blue R G4./a 7'—/a-_6_p
MAIL BUILDING /✓a, t 04
MAIL 152 Yorktown Lane ADDRESS ,� /� V'T.�
CITY Costa Mesa TIL' 545-508 ZONE ,�JNO. / El GROUP
APPROVED /vIS/�/- / /r
ARCHITECT TEL BY DATE
^ NGINEER Owner-Bldr. NO. S'
ONING
AIMRESS
ZONE NO.0 e._ I USE OF NEW I�AT10
Owner-Bldr. l -3 PLANS BUILDING COv�Q
CONTRACTOR `
ADDRESS LEGAL I „-r /86 ,, I l ACT G-I(OO
DESCRIPTION Vt�
CITY A.P.NO. I ¢I - 7O 1 - 3
TEL 30"
NO RAVE OVERHANG SHALL BE LESS THAN
STATE
SIC.NNO. 80'TO SIDE R REAR P.L
EAVES
SIZE
20 x 70 NOW OON LOT SLOGS. 1 ALLOWED (U.B,C.REQUIREMENT)
OF
USE OP YARDS APPROVED YARDS APPROVED
EXISTING BLDG. Residence MAIN BUILDING ACCESSORY BUILDING
b(FROM C/L STREET)
SETOACK LINK FROM FRONT ----- PT, pT.
CENTER OF STREET REAR YARD �T�
SID$YARD I LEFT RIGHT R.SIDE IT. r 7,./ . $� PT.
DESCRIPTION OF WORK L SIDE n Fr. PT.
' ALTERATION ADDITION J }[ REAR O PT. L n lid r XI 5I FT.
DISTANCE BBT. BET.MAIN S
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS.
BUILDING 1 NO.OF VAR.# DATE
SIZE 8 x 12 •ROOMS STORIES C.V.P.# APPROVED
EXTERIOR WALL ROOF Fiberglass AP
7ROVRDD L.-
�J'
COVERING COVERING SY �t�-�'�rf DATB _ 12-
68
USE OF BUILDING AND WORIQ81S1St FISMISRMED G
Add Patio Cover O
1
SQ.PT. X
I HEREBY ACKNOWLEDGE THAT.1 HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE C
AND STATE THAT THE ABOVE.IS CORRECT AND TO CON- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATIONLip
/1[43
BUILDING CONSTRUCTION.-.T��
SIGNATURE OF 7 12et, raLn
PERMITTER ) PERMIT FEE
128.00 PLAN CHECK S —7 '
IF w
AUTHORIZED AGENT 012 .
t ._.._. TOTAL FEE