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HomeMy WebLinkAbout3049 YUKON AVE - Building Permits PROJECT ADDRESS: 3049 YUKON CI . UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052254 dWIAWs NAME: MEDEIROSDEBORA ADDREss: 3049 YUKON CIRCLE PERMIT NO: E 052254 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA, CA CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: 0TH ARCH/ENGINEER: . REG.NO.: JOB DESCRIPTION : INSTALL SWITCH FOR AC RADIO CONTROL SQ FT: ADDRESS: UNIT: • CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / PERMITTEE: ELECTRICAL SYSTEMS TEST. ( 714 ) 898-5113 ADDRESS: 15573 COMMERCE LANE COMMENTS : INSTALL SWITCH FOR AC RADIO CONTROL HUNTINGTON BEACH CA 92649 ****+Eatu*+t+t*** Ett***** * $*****r. *?tu***********ta*TE*xx*v*star* +e*x*+8******ua<***T!*r+t* . LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in hilt force and effect. SETBACKS CITY IC.: 032193 sT TE Lic.:311709 CLASS: C 11..;?/ r0aie: ' //• q Signature: / _ . 4A '� MAIN BUILDING ACCESSORY BUILDING l WORKERS'C MPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT : FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation Insurance or a certified copy thereof(Section 3800,Lab.CI. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PDucy NO.: 10 4 2 9 0 4-90, EXP.DATE: 07/01 /91 COMPANY: STATE FUND PARKING REQ- PROV: PARCEL: 00000000 ZNE: REF NO: Ti Certified copy is hereby furnished. 1 Certified copy is filed with the city Building Division. ___-• /PLANNING NOTES> Cgae /l - 9/ Avcmwn �l � ' *************** **************************************************************** DEVEL OPMENT SER VICES R EQUIR EMENTSMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1W)or less). I certify that in the performance of the work for which this permit is.issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY . DATE: Date: Signature: NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; DATE Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. t M^ / ^, CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction tending agency for the performance of the work for APPLICATION ISSUED BY: �'/ / ` ' DATE- , 6 which this permit is issued(Section 3097.Civ.C). **************************************** *' ***************************/a(•3!*kTt at* LENDER: **************************************** ************************************ ADDRESS: LEGALIZATION:N F E •E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 70315 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 11 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed tj 0$ SM I P/NON—RES • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 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 L as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—D IV—> 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————> 11 . 00 15 . 00 0 . 00 26 . 00 26 . 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 er offered for sale. If,however the building or REVENUE DIVISION I S ION TOTALS——> COLLECTED: 26 .00 OVER/SHORT• 00 COLLECTED - improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC TIRE—SNIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 26' 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 ****************************************************************F ************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: • TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date owner: ELE 1 MISC APPARATUS NOT LISTED REQ PERMIT 11 . 00 11 . 00 I do hereby certify that tam 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. Dale: Applicant: I hereby certify that I have read this application and stale 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 -. pi"'t T iS- ita T. i ' k2i o property for lnspec is put �s, _ —- =—' [ Da7 le: �� Signature', xF/�' "" x" ' - Driver's License or Social Security#: 1641-46 While—Budding:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL ,PA _v APPROVALS Permit # tate 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Fouridation • i I 59. Gas Pipe, 0 Undrgrnd,, Test . • 9. Water Pipe-Undrgrnd. 60. Backwash Lines \P-Trap Undrgrnd. 10. Structural Floor System > 1, et 61. APPROV . .'C 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 Fireplacei - APPROVALS- Permit # 21. Ducts, in Structure . • 70. Underground:Hydro 22. Ducts, Ventilating • ' 71. Product;Piping 0 Gas ❑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 - t - • - 77. FIXED SYSTEM FINAL 29. Insulation78..FIRE PREY. FINAL -30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat _ . ,79. FINAL INSPECTION 32. Electrical Power Meter-Final FOOD CERTIFICATE ISSUED 33. Final Electric . , 7,-67,57i if./ Notes: - - 34. Final Heating & Air Conditioning , / 35. Final Gas Pipe-Test' ; ^ - - ' ' ' - r I - . -. _ - 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 I ` - 43. Backflow Irrigation • - 44. Landscape Irrigation System - - 45. Sound Attenuation - ' 46. .Handicap Regulations - . - 47. FINAL STRUCTURE& BUILDING - 48. FINAL PLANNING. 49. Electric Release to Edison "S - 50. Gas Release to Southern California Gas Co - - '^; - 51. CERTIFICATE OF OCCUPANCY - _ No Date S Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. .(4... - - - CITY OF COSTA MESA CONSTRUCTION PERMIT - PERMIT NO. I-II TRACT NO. LOT NO. UNIT NO. 9813 10/10/84 - 8.0[`1` TL 3Ci�-( Project Address 1 1UC1N NCRs/ ISO Illl - Applicant's Mailing Address ' \11xoo MOTb1Sh GG, TYPE OF CONSTRUCTION U NEW KY ADD U ALTERATION U REPAIR El CONVERSION C7 DEMOLISH ❑���{{{OTHER A.P.# Zone ' Owner's Name 9s2U.Q4- e7�1.Crtn.C1 Phone DESCRIPTION OF WORK/USE OF BLDG.' c / Address 301,4 .4 1.1‘,..0Y1OLV S Main Building: Accessory Building: - E Z w Arch/Eng. License No. TYPE OF PERMITt_d ❑ GRADING U FOUNDATION 0 STRUCTURAL T Front O ( Address • E. El TENANT ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear N IX Contractor's Name S'NS-none-Ivo ..� Va 'r1'`(`1_C� Ph,o er$•QS-511 ❑ 'OTHER C Right • N Address(mailing) xkter l 1 s tl�*O T` G.Cs . PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G CONSTRUCTION TYPE VALUATION$ $ Left !jI✓s City License No. 3�V43 ZONE _ _ GRADING CU.YDS. ACRES R �, LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E 0 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 • the Busi s a • •rofesslons Code,and mylicense is in full force and eft / r� p T License Class - S f Ueer �NO. '1\1'n CAS. pate \Or 3 - Signatur. rat PLUMBING FEES • WORKERS'COMPENSATION DEC - RATION Bar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a-certified copy thereof (Section Backflow Preventer Service Sink • Automatic Washer Transformer 0 15.50 KW 3800, Lab. C.) Policy NO.WtQ Ia014Q13 Company Stt QmQQ\C 4T\ Back(low Irrigation Sewer CapI 0 50+KW Construction Pole Sub. 8 Certified copy is hereby furnished. Certified spy is filed with the city BuildingCsl'Ick G Bathtubs Sewer Connection Cooking Unit I Meter ❑up to 100 amps Date ti) o Applicant shed 1 �V1 Il EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter ❑over 100 amps (This section need not be completed if the permit is for one hundred ($100)or - less) Dishwasher Solar Piping Dryers ❑Gas ['Electric 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 manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00.1 HP ❑1%-8 Workers' Compensation Laws of California, , Date Signature __ ---. Floor Drains • Swimming Pool w/Spa Inc.Solar F.A.U. 09-15 HP 016-15+ NOTICE:If,after making this declaration, you should become subject to the _ Workers' Compensation provisions Of the Labor Code, you must forthwith Floor Sinks Urinal comply-with such provisions or this permit shall be deemed revoked. Fixtures Microwave - CONSTRUCTION LENDING.AGENCY •' Gas Service Outlets . - Water Closet Device Boxes I hereby affirm that-there is a construction lending agency for the performance ' Pole Light of the work for which this permit is' issued (Section 3097 Clv. C.) Interceptors Water Heater Outlets Lender's Name Range , Lender's Address _ - Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION - • I hereby affirm that I am exempt from the Contractor's License Law for the , Lavatories - - 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 - 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 - � (�Q`� 1Q� a�1-:�1 nT c-0(21 t I CSL `•••� Division 3 of the Business and Professions Code) or that he/she is exempt „ C 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 nalty,of not more than five hundred dollars ($500): I ' z.DI I,•as owner of the property or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee- $ 3 compensation, will do the work, and the structure is not Intended or offered 1 —- Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business•and Professional Code: The Contractor's . MECHANICAL I 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 ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler . Hood or Type I ❑' - Approved sale. If, however,the building-or Improvement is sold within one year of com- Canopy Type 11 ❑ Zoning pP oved 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 strove for the purpose of sale). ^` U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • Application Issued By Datn I b(9) 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 , ❑0.100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- - tractor(s) license pursuaht to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ • PERMIT ❑.I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. (CBO# PLUMBING $ ISSUANCE $ Date - Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,00087 - - ELECTRICAL $ 'Fitt) GRADING $ ' information Is correct.'I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repro-. MICROFILM • $ sentatives of this city to enter upon the above-mentioned property pfotr PLAN CHECK 50% $ ingnature- N.�se\ (3 F t. Date\01-3_St\ TOTAL FEE ' $ CA.oO Signature- ♦�ek�s •. ..41n CMECHANICAL $ Drivers' License or SS� J • Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ' - ' CMF 0865-46,rev.4/84 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor - - CONSTRUCTION AND PLANNING POOL &SPA - APPROVALS Permit# f-/- 6'> Date Inspector APPROVALS Permit# 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, 0 Undrgrnd., Test 9. .Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 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 0 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 5,445-if?7 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 48. Special Requirements Completed • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 4`-On 9 CITY OF COSTA MESA • BUILDING DIVISION > %l t,, DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER be, a�masse PERMIT � '� B03-00077 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 3049 YUKON AV Status: ISSUED Suite: Applied: 01/15/2003 Vicinity: ROOF Issued: 01/15/2003 Parcel Number: 41806217 Zoning: R1 R1 Applicant: RON ANDERSON ISSUED BY: Address: 13052 EDWARDS Phone: (714)895-6677 WESTMINSTER,CA Zip: 92683 Owner: PATTERSON, TIMOTHY P Address 3049 YUKON CIR Phone: COSTA MESA,CA - Zip: 92626 Contractor: AFFORDABLE ROOFING & REPAIR Address: 13052 EDWARDS Phone: (714)895-6677 WESTMINSTER,CA Zip: 92683 License: 755616 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 7/16 OSB, 15#ASTN FELT,40 YEAR CERTAINTEED COMPOSITION SHINGLES.30 SQUARES INCLUDES GARAGE. FEE SUMMARY Plan Check: $0.00 • Calc Valuation: $7,000.00 Permit: $139.25 Claim Valuation: $7,000.00 SMIP Res: $0.70 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 , Total: $139.95 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 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 I (\ I e 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 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. y wo ers'tcco2ensation I urance er and policy number are: e/�7 p artier: (TA',P /Q/Ar Policy Number: /5 / n 9 ,5 - 6 Z� ( is section need not be completed if 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' _hould become subject to the workers'compensation provisions of Sectio 3700 f the Labor Code,I shall forthwith comply with these pr. oir Applicant Signature: .46i i...i awl Date: / At- 0 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI L P TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF E LABO CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions yhapter 9(commencing with Section 7000)of Division 3 of the Business and "rofessions Code,and my license is in full force and effect.tic.b ;gleClass# Contractor's Signature: ,.-"Zlz...._ . 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 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes ❑No Driver's 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 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 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application aggermit 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 LJ 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? ❑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: e Of Le.:I Owner(s) Date /C—S 40 - And/Or Authorized Applicant •-le CODE Y ly$PECTION TYPE DATE INTITIALS CODEC ill SPECTION TYPE OAIE IN11026.LS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof /_2-/.c?7 210 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 01•/20/2003 14:26 7143770270 AFFORDABLE ROOF _,�J 01 a CA/2_ S9 LV)A) PLcAse_ p(oyi tie rhe �1 � PtJ4 L pe/m i f CAC-0 S i G.,.)e.o con (-a r // ot,vN-€ R._ 4 4--- 3 D 447 yi44ri tk_ Ferri I 833-0D3-17 OL-.)tiler +) n�� J�v pkt- f( sot J — Co IJ ti-A0-for A ���(DA 2.0. C7 "7/ 11- a7 7 ttA e CALL W nl 12coeibli We WILL Lick -hi/4K) ) s Aa k) 1,06-7-A pig ) owo -/757 SUBJECT PROPERTY INFORMATION 1) Property: 3049 YUKON AV, COSTA MESA CA 92626-2919 CO20 APN: 418-062-17 Use: SFR County: ORANGE, CA Tax Rate Area: 15126 Total Value: $261,325 Census: 639.08 Prop Tax: $2,896.84 Land Value: $98,335 ' Map Pg: 27-F3 Delinq Tax Yr Imply Value: $162,990 New Pg: 859-05 Exemptions: HOMEOWNER Assd Yr: 1997 Phone: % Improved: 62% Owner PATTERSON TIMOTHY P Mail: 3049 YUKON CIR; COSTA MESA CA 92626-2963 SALES INFORMATION IMPROVEMENTS LAST SALE PRIOR SALE Bldg/Liv Area: 2,632 Transfer Date: 03/31/87 02/05/81 # Units: Sale Price/Type: $218,000 FULL $225,000 VERIFIED # Bldgs: Document#: 172002 #Stories: 2 Document Type: GRANT DEED $/SF: $82.83 1st TD/Type: $153,000 Yrblt/Eff: 1 Finance: Total Rms: 8 Junior TD's: Bedrms: 3 Lender: WESTERN EMPIRE Baths(F/H): 2 1 S&UIRVINE Fireplace: 1 Seller: BURTON BRUCE A Pool: Title Company: CONTINENTAL LAWYERS TITLE CO. Bsmt Area: Transfer Info: Construct: SITE INFORMATION Flooring: Air Gond: CENTRAL Improve Type: DETACHED Lot Size: 70 X 100 Heat Type: FORCED AIR Zoning: Lot Area: 7,000 Quality: GOOD County Use: 1 Parking: ATTACHED Condition: GOOD • Bldg Class: Park Spaces: 3 Style: CONTEMPORARY Flood Panel: 06059C-0047E Site Influence: Other Rooms: FAMILY ROOM;DINING ROOM Phys Chars: STUCCO EXTERIOR;PUBLIC WATER;PUBLIC SEWER;GOOD FUNCTIONAL UTILITY;RANGE OVEN;DISHWASHER;DISPOSAL; Legal: L2 TR10513/N Comments: • Copyright© 1996-97 Experian Page: 1 of 1 No. WILLIAMS INSULATION COMPANY OF CALIFORNIA 1201 E. Hunter Ave., Santa Ana, California 92705 (714) 972-9632 THERMAL INSULATION CERTIFICATION THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE. TITLE 24 STATE OF CALIFORNIA, IN THE BUILDING LOCATED AT: Tract Name: Lot No. �`�(2 � Tract No. Block 10513 Block No. Street 3D4q 1L.ktl\_ City CO-STA i?St1 EXTERIOR WALLS: - R— Mfg. Owens Corning Thickness/Type 6" Value 19 Ceilings: Batts: R_ Mfg. Owanc Rnrni nom_ Thickness/Type 3" _ _ Value 11 Blown In: p_ Mfg. Thickness/Type ' Value R— Sq. Ft.Covered No. of Bags Used _. Value Floors: R_ Mfg. Thickness/Type Value _ Other R— Mfg. Thickness/Type Value General Contractor California Contractors License No. Date Signature Title Williams Insulation Co. of California 0/6/T.: California Contractors License No. 267522 Date 4:` Field Supt_ • '- Signature Title JOB COPY-WHITE BUILDING DEPARTMENT-PINK GENERAL CONTRACTOR-YELLOW FILE COPY-GOLD - 3323 2/13/79 I eA ,� f; h _ - e - -� . 11 30 3323 2/ 13/79 1ICK L116 3323 0000447411 aid_ COSTA MESA BUILDING-SAFETY DEPARTMENT ci` P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only RECEIVED BY DATE RECEIVED BUILDING `/� ) /]� [� DATE ISSUED ADDRESS , 9/4Q Y (/ ezto �llL, . ` J(_Q C2 / PERMIT NO. OWNER Foley Construction Co. , Inc. A.P.NO /// MAIL BUILDIN G /� ADDRESS 2101 E. Fourth St. , #100 ADOREss3� UKQW CCK., L. CITY Santa Ana NO. 543-947 TRACT 10513 LOT 2 BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVINfl _DEMOLISH LENDER X BRANCH OWNER Foley Construction Co. , Inc. r ADDRESS ^/� // ''rr VALUE§Bona-oa ARCHITECT Hales-Langston NOL- 547-0862 USFPc2 /Q"X"V FIRE ADDRESS 777 S. blain; #105, Orange ZONE TYPE IV GROUP---TN- AP ROUP %- CONTRACTOR Owner/Developer BYPROVED DATE I ADDRESS Same S ZONE NO.OF USE OF NEW Same NO. TEL. I PLATS a BUILDING DwP 3 h CITY h9 J F STATES+ CITY YARDS APPROVED YARDS APPROVED allie LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING iU SIZE NO.OF BLOCS. (FROM C/L STREEL� PL YvkOn G r, n. OF LOT NOW ON LOT 0 FRONT an FT. I FT. USE OF )j,( r C EXISTING BLDG. N/A R.SIDE I-1- FT. (3 FT, CA E-. Separate permits are required for L,SIDE S FT. 0 FT. electric,plumbing and heating work. /�/ W ^�REAR 'all FT. 6 FT. (-• USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& GMAIN SLOGS. ACCESS SLOGS. Development of 41 sing-family CURP,gp DATE APPROVED rresidence units (detached) Fav RD( air G DATE . — l h--7't .a 1•1•1 O I hereby acknowledge that I have read this application and state r f ` pQ that the above Information Is correct and agree to comply with HOW TOR SPECIAL REQUlkm vclylcty t a ` L all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of J = the State of California. �t2� ^� ZZ m Ct I hereby certify that I am properly licensed as a contractor under 2.600 SQ. FT. • togs, the State of California Business and Professions Code. Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m s 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 and Professions Code,Division 3,Chapter 9. PERMIT FEE $ n aV..50S /J S /gooPLAN CHECK $ ! o Signature qty//�' / ryam _ $_ TAX § ,6;i0/ f Signature lr+/7 vv ` �r0�j// u. U Authorized Agent TOTAL PAID $ i /! 97� // _ _ - -. 5726 3/27/7.9'-" `' 249g pp / 06726 3/27/79_ __ 2491&& COSTA MESA BUILDING-SAFETY DEPARTMENT IIt5726 000Q4474 I I 'IA — •• P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 Mt(v) APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only /� RECEIVED BY DATE RECEIVED DATE ISSUED ADORENGcL/n v yo / I sQ ADDRESS �_/ ( /VJ Iv/t-- ^ .. rY PERMIT NO. OWNER 1 t,\.lr+J �][t)/�l�l A.P.NO. ///��r MAIL BUILDING /1 J q �f1 '<Q� esi•Q ADDRESS ADDRESS (1���///T��/ ] V TEL. TRACT O r LOT a BLOCK CITY NO. 1r�— _.I} CONSTRUCTION NEW ADO ALTFR REPAIR MOVING DEMOLISH LENDER BRANCH �� Ce IA n_ n t1 OWNER wy(A'y� ADDRESS VALUE ARCHITECT TEL. S OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP /Q� APPROVED CONTRACTOR / d' BY DATE ADDRESS TEL. ZONE NO.OF USE OF NEW PLANS BUILDING CITY NO. Fv. STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE NO.OF BLDGS. (FROM C/L STREET) 0. OF LOT NOW ON LOT FRONT FT. FT. G USE OF EXISTING BLDG. R SIDE FT. FT. CM FSeparate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. REAR FT. FT. W USE OF BUILDING AND WORK TO BE PERFORMED [ DISTANCE BET. BET.MAIN& QC MAIN BLOCS. ACCESS.BLOCS. VAR.& DATE ', C.U.P. APPROVED -C APPROVED _BY DATE W 0 I hereby acknowledge that I have read this application and state n C that the above Information Is correct and agree to comply with m O. all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of o yam" the State of California. m I hereby certify that I am properly licensed as a contractor under SO. FT. H the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR a Chapter 9, and that such licenses are in full force and effect,or I THE PURPCGE OF ESTABLISHING A PERMIT FEE ONLY: •' am exempt from the provisions of tho State of California Business VALUATION PERMIT FEE E� CO and Professions Code, Division 3,Ch.• .r 9. n AO PLAN CHECK $ c PSS'I • u. Perermit%in �((// / ' • $ TAX S / Authorized Agent TOTAL PAID Epyq,3 -U