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HomeMy WebLinkAbout3109 YUKON AVE - Building Permits • 44e, NMF 9 CITY OF COSTA MESA ` qc BUILDING DIVISION F %I $ DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER vii 1 PERMIT 4 P06-00177 --e o ofi' (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 3109 YUKON AV + Status: ISSUED Suite No Applied: 03/15/2006 Issued: 03/15/2006 Vicinity: Parcel Nunmber: 41805115 Applicant: LITTLEFIELD, SCOTT ISSUED BY: Address: 24707 SAN FERNANDO RD Phone: 661-259-7131 n �/�. o SANTA CLARITA,CA Zip: 91321 v 'V'--� Owner: STAMPA, JUERGEN Address PO BOX 7921 Phone: 949-202-6403 NEWPORT BEACH,CA Zip: 92658-792101) SIS ►►V Contractor: AFFORDABLE WATER HEATERS AND PLUMBING • Address: 24707 SAN FERNANDO RD QOI Phone: 661-259-7131 SANTA CLARITA,CA Zip: 91321 License: 627368 SCOPE OF PERMIT 1 WATER HEATER CHANGE OUT. • FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 _ Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 r Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 1 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS/SPECIAL CONDITIONS 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' 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 ork for which this permit is issued. �ve 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. orkfrs'compensation!Insurance carrier and policy number are: ardor: I kQ tt' tt olfcv Numer: 10& ') c-4&7JI (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) J ❑ I certify that in the performance of t e 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, d agr at if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith cam. :provisions. Appli . k D>le. 3- is- oh WARNING:FAILURE TO SECURE WOR RS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN A ITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706OFTHE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED • RACTORS DECLARATION: I here. ,,.atuj i'ta.z m licensed under provisions of Chapter 9(commencing with Section 7000)of Div'' Business and Professions Code,and my license is in full C e and r' t Lia a \\ a C°. 7Co- {1 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑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 h of the California Health and efety Coder a requires,with some exceptions,matrthat a toinr Plan lad with the Costa Mesa or a mof lions, or 2100 which has o anyr one time duringt areported aa 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? ❑Yes ❑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 HtaltA 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 a_permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes 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? ❑Yes ❑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.1 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. Signature Of Legal c nen(, . Date And/Or Autho' -.A..' • D CODE• INSPECTION TYPE �` - INTRIALSS' CODEX INSPECTION TYPE DATE INTTALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 3'13 -(/d f 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 'ROJECT ADDRESS: UNIT: ("4= STAMPA, AVN CITY OF COSTA MESA BUILDING PERMIT PERM NO: B 058545 AZgREss: 3109 YUKON AVE PERMIT NO: B 058545 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT ARCH/ENGINEER: 754-6950 REG.NO.: JOB DESCRIPTION : T/OFF RESHT. REROOF 1280SQFT W/COMP SQ FT: 1 , 400 ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: 1 , 400 . 00 CALC—VALUE: 1, 400.00 GROUP OCC: R-3 / ADDRESS: JUERGEN P. STAMPA ( 714 )754-6950 0 3109TA YUKONA AVENUE ********+1+E• ******D**********#****D*******r+Ht*+Mt*********�r�E*�E�E**�E**�E�E******�E******* COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: heraffirm that I am licensed under provisions of Chapter 9(commencing with Section - Z O N I N G REQUIREMENTS 7000)of Oiwsan 3 of the Business and Professions Code,and my license is in full force and effect. • SETBACKS CITY tIC.: STATE LIC.: CLASS: Dale: Signature: _ MAIN BUILDING ACCESSORY BUILDING WORXERS'COMPENSATION DECLARATION: I hereby alarm 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.C). LEFT: FT ' IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 41805115 ZNE: REF NO: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> C..> gate: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). DEVEAJOPMEN T SERVICES REQUIREMENTS I certify that in he performance of the work for which this perm is issued I shall note any person in any manner so as to become y. subject to]�'p/workers'Compensation Laws of California. (ryple�y. ZONING APPROVED BY DATE: —� Dale: CE f 10 •a 9i Signature: : '-•1 x^"v'v NOTICE:If.after making this declaration.you should be a subject to the Workers'Compo tion provisions of the Labor BUILDING APPROVED BY : t" DATE: Code.you must fodhwnth comply with such provisions or this permit shall be deemed revokedt 7.G CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work far APPLICATION ISSUED BY: L — 411157 DATE: which this Permit is issued(Section 3097.Civ.C). ********************** LENDER: ADDRESS: LEGALIZATION:N F E E S U M MARY STRUCTURAL SEGMENT:Y 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 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 33. 00 Y 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business • ., , 7 $MIP/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(5500). ISSUE FEE t4 ' - ,,. 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 ' ' - a DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 3 3. 5 0 0. 00 . 0. 00 3 3. 5 0 3 3. 5 0 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himsell/herself or through . or his or is soln dbwithin provided ne year of completion,improvements owner will have the not e burden of ed or red for sate.If,proving he/she did not bur ild or improvee iREVENUE DIVISION TOTALS——> COLLECTED• 33. 50 OVER/SHORT: - 00 for the 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 33 .00 "eV . 50 ''1/ ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon J 2 a and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******,*,***,**,*********,*****N,****,***.***,******,***,N,***,************,*****,*********,�* that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A' L. F E E BREAKDOWN RII am exempt under Section: BP 70 4 4 B S P C. � . ,', m�r n�ID 9±aL WORK BY OWNER Pc �,,,,,, z TYPE QTY DESCRIPTIO N UNIT COST fTOTAL COST -Date: Owner fid"•, �` I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 1400 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 400. 00 25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a / t 'EfND OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from :f• a these provisions. EXPIRED Date: Applicant. incomplete Inspections r 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 , j ordinances and s ate laws relating to building construction and hereby authorize represent.' 's of this city to enter upon the above-mentioned , — j property(11tr'�n. eclion purposes. Date Sig• ''(,/Ilyvr,l� �mate: U11 /0-92_ �7—9 Signature: I r P i !'� '{ �r _ . Driver's License or Social Security a: I (_ �� 164646 White—Buddino:Green—Code Enforcement;Canary—Aoolicant:Pink—Revenue;Goldenrod—Assessor IIJJ i I_„__coNSTRUCTION AND PLANNING POOL PA -.1APPROVALS Permit# I Date Inspector APPROVALS Permit # Date Inspector �1. temporary Electrical Service or Pole 52. Pool & Equipment Location , ' l 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement t'3(Electrical Condt4L.Utility-Undrgrnd. 54. Forms . ••4. Electrical Conduits-iJreirgrnd. 55. Electrical Bonding ";5.•St el Reinforcement, 56. Rough Plumbing & Pressure Telt ' . 6: Electrical OF ERtnd. 57. APPROVAL TO COVER-GUNFTE ,7.•„Ootings56. Electrical Conduit-Undrgrnd. r `'..9:,,' Foundation . 59. Gas Pipe, 0 Undrgrnd., Test - • 9. Water Pipe-Undrg(.ed. - 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 ElectricajT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . - r .1 20. 'Rough Factory Fireplace -L ; t - . t •APPROVALS2 ;Permit # - T t;' v. , r' i 7 T ../. . I • 21. Duct`s, in-Stri,}eture; r. _ _ ?r .. 70. Uridergrourld)Hydto t 22. Ducts, Ventilating ! � .. _ .r . 1 x -,71. Product•Piaing O'G•s ❑Oil 23. Gas Pipe-Rough&•Test I .t j; ; X72. Underground Flush=,.- ., 24. 'Roo;Framing! .' C YT •?* t 73.9Undergrnd:Storagp-Tank 0 Gas ❑OW • 25. Root Sheathing ;it.,t., 4ie -/(yy.`l, Cu,bi. ; '74.;Overhead I4ydro - -' .". 26.•'-Ba, Ceiling (Structural) & Monocoat a •n -i .: . , 75. 'Dry Chemical 27.' rame and Flashing' to " 76.`DPy Stand'1 e = .1 � it 4 2,J'Y r J. �F� l? 28. Lathjng & Siding` ,. ,.= ' , •• , 77•;FIXED SYSTEMjF{'NAL - r 29. Insulation • - j • -' ' " I f` .; 78.RIRE PR EV. FINAh :. ,.c r , 30. Drywall Nailing • - a u P • - HEALTH DEPT..REQUIREMENT • v - e 31. Plaster Brown Coat • ,r..,_ ' rr - .79.-FINAL INSPECTION ,': - - aa, 32.•-Electrical'Power MeterFinal : - > -i+ � , i* . r•80.,,FOOD CERTIFICATE ISSLIED 1 33. Final'Electric ,: r i ,r � , 1` 4v -'Notes: _8-f'(`h--5 �..-, m� / , •1.34. Final Heating& Air,Conditioning- n . r u .1•:‘,...144 35• . Final Gas Pipe•Tef( .1 , r7 ant,t 'i' -I ~ a t. --. .. . I T:. - - .. I x ,S •36.' - Hood or-Canopy :2-- ,I . -• . I. ,. a• .^ - 37.'Fina-Factory Fireptace r -tet'' •``• ; S ;• . y -. - 4 r -, - 38. Final'Plumbing . -; • •n • -39. Water Sedvice-Finals i ' * 'I - : - :40. Gas Service-Final - ' •' - - , ' . ;41. Solar Domestic-Final - •- • C - r, n I ; 42.'Backflow Preventers .ti I. 'l R -a. ;' - 43. Backflow Irrigation •\ >S '' • 7 'L;-L •• ,_ - • . :44, Landscape Irrigation System..J„:- . n - , . :. ' t45.!Sound Attenuation• ._ . tr 'r i,I „'s •• °r •A6. Handicap Regulations •' ."' " " •" :. ;• I ' s'�jtpl••te lnspe •47. FINAL STRUCTURE & BUILDING • a - °.•.`a 3 p3 Si$ 48. FINALPLANNING' I �( 1 -' I.V h 1- -49. Electric Release to Edison r i _ .50. Gas Release to Southern California Gas Co ',' ! , :,' • 51. CERTIFICATE OF OCCUPANCY . ..„ .--•• . No. Date L s N • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA SON T' UCTION PERMIT _pig M359 4 Z TRACT NO. LOT NO. UNIT NO. A P I Zone Project Address 3 -- e! �y/ S Main Building: Accessory Building: Applicant's Mailing Address TYPE OF CONSTRUCTION U NEW L7 ADD LJ ALTERATION H REPAIR�� ❑ CONVERSION ❑ DEMOLISH ❑ OTH�jR T Front G Owner's Name p•\ N A f •hone id DESCRIPTION OF ORK/USE OF BLDG. /'L-o 1•Qa✓ / • B Rear N Address 3/� / /(on/ AVOM .OX � re feet �• C Right N g Arch/Eng. License No. TYPE OF ERMIT Ell GRADING FOUNDATION STRVCTV RAL K G Address ,r. q Ura ❑ TENANT ELECTRICA ❑ PLUMBING[ l (❑/MECHANICAL $ LeftR Contractor's Name C V/, Phone (•s7��G CI OTHER tut 5 Sal�J a ys�TL`�+ ••�� Ping. Ref.# Parking Req./Provided E PROJECT DESCRIPTION OCCU ANY Q Address(mailing) �s Planning Notes: M CONSTRUCTION TYPE N VALUATION$ 1J22 way T City License No. ZONE GRADING CU.YDS. ACRES L - • • ONTRACTOR DECLARATION S. I hereby affirm tha .•• icensed under provision • : • commencing Remarks( J f f with section 7000) of Divls • •1 •• ess and Professions Code,and wX 0' jl �{���-s� my license is in full force an• 1t...5••-n A 7 p /I IXM/ ./._ y /• ELECTRICAL FEES License Class L c. : •• 1�j `� T ( !-PM \.a D. - Signature PLUMBING I FE S Automatic Washer Transformer 0 15-50 KW OR KERS' COMPENSATION DECLARATION Sink Showers Construction Pole Sub. ❑ 50+ KW I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter Dora to 100 amps 3800, Lab. C.) - Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps Dr U Certified copy Is hereby furnished. ` Certifi-• co. fil-d with the city Bui:L a• i-rte Bathtubs Sewer Connection Dryers ❑Gas ❑Electric Sub Panel Dat. r07tZLVni .---•-. --•-•02"eT�aa,---___ sve _ 4_- Fan Motors❑0-1 HP❑114-8 EXEMPTION FROM WORKERS'COMPE ATION • CLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100) or F.A.U. Inc.Solar ❑9-15 HP ❑16.15+ less). Dishwasher Solar Piping I certify that in the performance of the work for which this permit is issued, I shall not employ an person In any come subject to the Drinking Fountains Solar Tank Fixtures Microwave Workers' Cor}�e sa ws of CalifO Device Boxes Date /el i Signature at—oftFloor Drains Swimming Pool w/Spa Pole Light NOTICE:I after making this declaration, you sho -(become subject to the Outlets Workers' Compensation provisions of the Labor ode, you must forthwith Floor Sinks Urinal Range comply with such provisions or this permit shall be deemed revoked. - - Switches CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Sign ' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097 Clv. C.) Interceptors Water Heater Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION 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 county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays • any structure, prior to its Issuance, also requires the applicant for such permit 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 . . Division 3 of the Business and Professions Code) or that he/she Is exempt Reinspection Fee I $15 Issue Fee $ 3 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 DEVELOPMENT SERVICES REQUIREMENTS: U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee S 3 compensation,will do the work,and the structure is not intended or offered . Zoning Approved By Date for sale (Section 7044, Business and professional Code: The Contractor's MECHANICAL FEES Building Approved By Date 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 Application Issued By employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ Data sale. If, however, the building or improvement Is sold within ono year of com- - Canopy Type II 0 , elation, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground SUMMA Y OF FEES � prove for the purpose of sale). - BUILDING PERMIT $ /0 5• GC SMTP $ •1-+ /s. I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK �� tractors to construct the project(Section 7044,Business and Professions Code: $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0O-100,000 BTU 0100,000 BTU • $ PLUMBING, ISSUANCE $ builds or Improves thereon.and who contracts for such oroiects with a con- _ _ tractor(s) license pursuant to the Contra4tor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. GRADING $ J I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers ELECTRICAL $ PLAN CHECK 50% $ MICROFILM $ . Date a owner Heating System& Ducting Registers MECHANICALp1 I hereby certify that I have read this applic on and state that the above ❑O-100,000 BTU 0100,000 BTL $ TOTAL FEE $ l�Q IrNormatlon Is correct. I agree to comply wit all city and county ordinances PLAN CHECK 25% $ and state laws relating to buil construction, and hereby authorize repre- sentatives of this cl en on the above-mentioned property or Inspection purposes. /yyy'��� y Signature Date Reinspection �p Drrvers' License or SS 9f Reinspection Fee $15 Issue Fee $ 3 01 00018166-0018167 TOT ICS ` `\0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 10/31/ES TIME: P:16 _ 1 POOL &SPA 1 N. CONSTRUCTION AND PLANNING APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole I I 52. Pool & Equipment Location •, 2. Soil Ripe-Undrgrnd. . 53. Steel Reinforcement 3.1 Electrical Conduit Utility-Undrgrnd. - 54. Forms • ' i .. 4: Electrical Conduit-Undrgrnd, I 55. Electrical Bonding I I I L.5.•Steel ReinforcernRnt !' 56. Rough Plumbing & Pressure Test 6.' Electrical UF ER Grnd. •` 57. APPROVAL TO COVER-GUNITE •+ - - '7..Footings 58. Electrical Conduit-Undrgrnd. `it • I I 87,Foun'1aiion I 1 59. Gas Pipe, 0 Undrgrnd.,Test : ' � 9.'Water, Pipe-Undrgrnd. i60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System t _{ ` . . 61. APPROVAL TO DECK • 11. Property Sewer Line & Hoase Connection + 62. Backwash & Receptor-Final I 12. Sewer Cap - I ` 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 1 1.7. Rough Wiring Sign . 68. APPROVED FOR PLASTERING '18. Rough Electrical-T Bar Ceiling "' 69. POOL/SPA SYSTEMS FINAL 19. Rough Beating & Air Conditioning FIRE DEPT. REQUIREMENT -20. Rougb,Factory.Rireplace i r APPROVALS Permit# 21. Ducts, in'Structt re • � 70. Underground Hydro 22. Ducts, Ventilating;'i ,:.''• 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough ,Test I 72. Underground Flush - 24. Roof Framing• t• .I - • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25/Roof Sheathing.' i74. Overhead Hydro 26. T-Bar1Ceiling (Structural) &'1171onocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulaltion •I ^ 78. FIRE PREV. FINAL r • 30. Drywall Nailing • i. HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . 79. FINAL INSPECTION 32. Electrical Power Meter-Final• 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: plQ © ...e._ ./4.7.0....e 34. Final Heating & Air Conditioning ///jg g 35. Final Gas Pipe-Test /L� 36. Hood or Canopy it/e.t/re.././ "cy� .41/1--' - f//3r 37. Final Factory Fireplace 38. Final Plumbing cave gir/o�'cv(av 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final l 42. Backf low Preventer 43. Backflow Irrigation 44. .Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations / ,� 47. FINAL STRUCTURE & BUILDING /1/4/g 9.-- `l _ ' 48. Special Requirements Completed r/ , 49. Electric Release to Edison j 50. Gas Release to Southern California Gas Co ,• , 51. CERTIFICATE OF OCCUPANCY >t No. Date I, b'Hlk{LP:Y, UUhT.Lb JOB ADDRESS 3J o9 y,�kon gyenue BUILDING PERMIT NO. 28424 GENERAL CONTRACTOR mer-Rill Ices' DESCRIPTION of WORK Community Block Wall A° No. 418=051-15 LOT TRACT 1}(74 FIRE ZONE VALUE $75.00 S` " ECTIONS Signature Date GROUP ,T TYPE I ZONE B-1 SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM - MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING rn Heating and Vent. TRENCHES Q' FORMS 0 STEEL REINF. Ell YfY''vtf- welt—b9 FLOOR SYSTEM / BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN fl OUT n PLASTER, BROWN COAT S- 'CTURAL, FINAL Electric I NG, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST 011 ELECTRIC, FINAL ��4q- .)---0/ _ BUILDING, FINiAo c..cure al 28424 ►wx-s 00 516 J*****2.00 / COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 32S20 For Applicant to Fill In Comp/Sly APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDING J y A'a."-' v•C ADDRESS J '/ v^ pi RECEIPT NO. /1Q4R'D 116 COSTA MESA. CALIFORNIA /(,J�4:G�'1' y/ RE II�/[D BY /PRATE RWEIVED... ��y/' DAT IBB EDD OWNER Cl/.4N T/~f f// /ffLL ,/ L.A�•!.c/ l 7/yJ—�O®''�,I/�( ^ Q�_�6 MAIL pile 9 ye.,"A-0---,-- RINE• AD RES$ \/D/ (AU!(�!/l./ I VU• ADDRESS S •� V// CITY(-a;Tel- /VJ�1'i9- No ZONE TYPE GROUP APP VRD e 9 0nCHITECT TEL BY i:e _rpm ?Vie/ DATE 1/ ' 'NGINEER NO. �", ZONING 1-4-7----n---ni ADDRESS -4 TONE//01� NO.or US[or N6W /I O C • \ PLANS O BUILDING /•/��-/1 , CONTRACTOR CJ 1-/L.01.//5€1. L- I Let t ('��/ /1L'� DESCRIPTION L-�/l l+'-- `l6 < Li ADDRESS � //{{,��� (/ CITY A.P.NO. `it t/ - O sl- I S NOTE: NO HAVE OVERHANG SHALL BE LESS THAN STATE TEL EO'TO SIDE&REAR P.L LIC.NO. NQ, SIZE /� / EAVES OF LOT 0 / / X I00/ ,T I NOW ONL.oT . / ALLOWED (U.B.C.REQUIREMENT) USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET • SETBACK LINE PROM FRONT CENTER OP STREET REAR YARD �c�' FT. I �I � SID[YARDI LEFT I RIGHT R.SID[ ®FT. �T/�?J• 6 Cpr:175 DESCRIPTION OF WORK L.{ID[ PT. FT. �f r ALTERATION ADDITION x REAR FT. Fr. DISTANCE BET. BET.MAIN e MAIN BLDGS, ACCESS.SLOGS. REPAIR -MOVING DEMOLISH BUILDING NO.OF VAR.# DATE SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL I ROOF APPCOVED, ( c COVERING COVERING BY /e�'1 � '/p _....71 DATE ��� -\9 1 a USE OF BUILDING AND WORK TO BE PERFORMED l �O'/`[/Yf/.Ill/''i Y o /� Lt w /L 2t2•e to o?Y�/off {Q.FT. Z I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j AND STATE THAT THE ABOVE IS CORRECT'AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. e�A PLY WITH ALL CITY ORDINANCES AND ETAT S REO TINS BUILDING CONSTRUCTION. VALUATION �J/`7�/I 81GNATUR"•F /'/ �/• / PERMIT FEE 5 CRE/72 01 PERMITT - - U a 5 7�(/(;/ PLAN CHECK S AUTHORIZED AGENT /}�/] WE#r2l��Ir Pi! p) ('♦�'p�y� TOTAL FEE $�// // OWNER cuRn SHIRLEY DATE 8/8/$0 JOB ADDRESS 3109 Yukon Avenue BUILDING PERMIT NO. 50479 • GENERAL CONTRACTORBazorback Builders, Inc, DESCRIPTION of WORK Room Addition AD No. 418-051-15 LOT12 TRACT 4.74 FIRE ZONE VALUES 4,330 00 ECTIONS Signature Date TYPE V GROUP I ZONE SUBCONTRACTOR PERMITS ISSUED GAS Dote Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE HOUSE CON. • SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING (IA'I nC �'�-� �H�eattiing and nt. G^ F(;:/� TRENCHES fa FORMS 64 STEEL REINF. 2 iya) seism �/T70 Cir rLeees / -o,a-S7.., /7V99I FLOOR SYSTEM ^ I I / BOND BEAM IT STEEL REINFORCE 1 1 1J SHEATHING a 1�-7 5 FRAME AND FLASHING (/ . -'i / L O LATHING — IN n OUT �� �i/�/, ▪ PLASTER, BROWN COAT pre .9 r-"'CTURAL, FINAL �) I NG, VENT.. REFRIG. AND A.C., FINAL / ./� ,jT ' in PLUMBING. FINAL AND GAS TEST ri .r .—I ELE RIC. FINAL C.C. /O-1(.-Ct ARMWAVAMWA ' B UUI DING. FINAL u.cure IIICeirlirMillif ions CN Ozett-t_. ve, Ii. J ' CO ST MESABOX IILDIA NG- SAFETY D PAIRAT MEN T APPLICATION FOR STRUCTURAL PERMIT PRE V PERMIT ' For Applicant to Fill in Completely — Use Ink Only T6�io 1Y77RD a iM}an 5 Q 4 7 9,6- 50 tc BUILDING O s ,A.P.NO.4/8 —� /5 ADDRESS BUILDING �J Q OWNER OR /' `/' / ADDRESS 3107 / TENANT 1./Nf1 S _l�/In/C (, t / UNIT OR MAILING I/ SPACE NO. ADDRESS �/� C/ J� �d Vj TR.NO,./moi/_ LOT /a_ BLK. / ./1 ( TEL / C � !�, 4 �7� CITY 5 7 NO TEL.. NEW I ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION Cu, / F LENDER [� / �e ^) BRANCH GQ.S �GL 772e---.54. F/.(` rA `�/ I� OWNER V N /V'��Lt/ITZit(ff/.rjr— ADDRESS �7 y UE USE , slat 3../V ARCHITECT D �// //�� NOLb7�3 /� / OR ENGINEER / if ADDRESS 4• S /-Rn ` Q{/�d/' ZONE TYPE GROUP �/y CONTRACTOR /7R 2/1rfJ(r c/( �/1 �/'S Inc/ AgYPROV ED DATE dreier° ADD RESS 2 JZ /Pn CIC� /7) yam'/ 111 I — I–. //erPMAef&LA? NO. /yS%S4t CITY rpm I APPROVED SETBACKS STATE BOJ CITY LIC. NO. LIC.NO. is SIZE 'NO.OF BLOCS. (FROMC/LSTREEEET)� a. OF LOT/DO oC X (7 L NOW ON LOT NT 6a+f.JYrC3/ J USE OF ^ / // z EXISTING BLDG. R eS/ fd/)C.e, IL SIDE fT. 0 Fz• Separate permits are required for L.SIDE I • FT. 1– electric,plumbing and heating work:15 REAR /� 'FT. '/ -- I.. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q / / '{e S /(/FnCE t gig 11 IaI DATE "� APPROVEDe-8-8e, �e Q� >. /'OOirt _av ROVED�fyy/� IN DATE V VOCE W IQ L • I hereby acknowledge that I have read this application and state 0 a that the above information is correct and agree to comply with 9. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of 42 ,WS, the State of California. /�/ as I hereby certify that I am Properly licensed as a contractor under !/ SO. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR w Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: – to am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ < and Professions Code Divi on`Chapter 9. /G s®� v+ / /$ o PLAN CHECK $ OG C Signature 0::::5774.11111L. �� 2 a Permittee Or ` $ 1C 3 Jct TAX s (:)..Co f Authorized Agent Date / �- �� �/ TOTAL PAID Stilt Sa U �1 Ot lAl6i r GU1cX.W W. vhlL l tv w $JOB ADDRESS 09 Yu}Lon_Avenue BUILDING PERMIT NO. 28825 GENERAL CONTACTOR Owner-Builder DESCRIPTION of WORK Patio Cover AP No. 14.18-051-15 LOT 12 TRACT L674 FIRE ZONE VALUE $595.00 `ECTIONS Signature Date GROUP J TYPE ZONE R-1 SUBCONTRACTOR PERMITS 15� UED GAS Date Number I Signature y WATER Plumbing ROUGH PLUMBING l PROP. SWR. LINE fl HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER n ROUGH WIRING � Heating and Vent. TRENCHES 6a FORMS 0 STEEL REINF. �/y�L.f- 1"' FLOOR SYSTEM BOND BEAM r] STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATIOID OUT n PLASTER, BROWN COAT STRUCTURAL, FINAL Electric 1 NG, VENT., REFRIG. AND A,C., FINAL Pi_ AGING, FINAL AND GAS TEST r] ELECTRIC, FINAL BUILDING, FINAL 4rl9W /o t-4( SPECIAL REQUIREMENTS 28825 M 10-6SMAOO 744 z*****5.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDINGS/6 9 YUKO ic.l "f i/6— For Office Use Only��/)/��•�{{//////�����T ADDREHD RECEIPT NO, 2Vi1120. COSTA MESA. CALIFORNIA RC .YT HRHCH IVD DATE)", D OWNER even 5 R^ • sH1L C-/ ( R / ) _ -- DIDLRBHHtc�i,ie_ ADSG 3/09 pAe ��,•l72, ONA ? / \ TYPEt LP -• P CITY ppO S Y0^ Sjeg� NO. APPROVED // ll r H ITEN ECT BR TEL 2C4 NO. BY V I: TE / ,o NGI ING ADDRESS /� B warp�j NO.OF USE OF CONTRACTOR OCDCR - $U/LpEC_ /C � I PLANS a I EUILOING f ).� ADDRESS LESCRimON 7, /4 I,7A>, 3/4‘71 G// CITY A A.P.NO. ...9./ / ./7-1 DS Ir.4C STATE TEL. NOTE: NO HAVE E OVERHANG SHALL BE LESS THAN BO'TO SIDE a REAR P.L LIC.NO. NO, EAVES SIZE NO.OF ELDOE. ALLOWED (U.S.C.REQUIREMENT) OF LOT -f,jl,1/, J)' k //j/JC NOW qN kGT / YARDS APPROVED YARDS APPROVED USE OF • MAIN BUILDING ACCESSORY BUILDING (nil$ EX I ST I NG BLDG. iy1 CIS • SETBACK LINE FROM J / le. C/L/GT [ ) CENTER OF STRAIT ! �o REAR Yill 'AARRDD�/�'�"J"'� PRON'�J/A date, FT, SID1C YARDI LEFTI RIGHT 7 R.SIDE .�FL / FT. DESCRIPTION OF WORK , L.SIDE 4 PT.-(' FT. FT. R (/) I T ATI N ADDITI N REAR /a PT..6 FT. DISTANCE BET. BET.MAIN a REPAIR MOVING; DEMOLISH MAIN BLDQ$, ACCESS.BLOCS. BUILDING NO.OF r VAR.# DATE SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL I ROOF /Q e`ua BT(�,/.IT Mr COVERING COVERING . V DATE / ` tU—� U USE OF BUILDING AND WORK TO BE PERFORMED IF cg..----e4 t a DI en-Jo coo aEde BQ.Pr. x I HEREBY THAT T EDGE THAT I HAVE READ THIS TO COM. THE AMOUNTOF SHOWN UNDER VALUATION F FOR THE AND STATE THE ABOVE IS ANDCORRECTSTATS AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FHB ONLY. 313 PLY WITH ALL CITY ORDINANCES AND ETATS W EOULATINO VALUATION BUILDING CONSTRUCTION. /}./� SIGNATURE OFL��C PERMIT FEE $ • [/(/ PERMITTED ^•"!/K�!/ .Q7. /'�n/•d - Go L�'//7/L'�^'/. h_(� PLAN CHECK i k' AUTHORIZED AGENT «.. - o... TOTAL FEE 6F5•(7-0) OWNER SHIRLEY, Kurt DATE 5-28-75 JOB ADDRESS 3109 Yukon Avenue BUILDING PERMIT NO. 40040 'GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Blockwall / 0. 418-051-15 LOT TRACT FIRE ZONE VALUE $ 500.00 4IIN.rECTIONS Signature Date TYPE JJI GROUP J ZONE RL ?1SOIL SUBCONTRACTOR PERMITS ISSUED cAs Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. C] SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS 0 STEEL REINF. G✓/ t If r7,5" FLOOR SYSTEM BOND BEAM 7 STEEL REINFORCE fl SHEATHING FRAME AND FLASHING LATHING - IN in OUT n PL"TER, BROWN COAT H CURVE, FINAL HEw,ING. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC. FINAL • �q / BUILDING, FINAL e /A•y 2y_. • PAID "Ix 7£375tJU1o76 + + t*5.50 40040 "` COSTA MESA BUILDING-SAFETY DEPARTMENT - P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT jj RECEIVED BY DATE RECEIVED DATE IS LIED BUILDINGS/07 q '1 i�%S,a `� ��Y ADDRESS �/_///((''11 fT O A.P.NO. Wer-057,_ `S PERMIT NO. OWNER /1-LI/irT 5,A0144"7 q MAIL BUILDING i//.�y' ADDRESS 3/t/ V 4, /S.OI0/ ADDRESS 3109 t'uKo rT lr w W q TEL. [J ^�[/ EL O CITY e p97-. NO. ain ././ TRACT TRACT 7�/ / I LOT /2_ BLOCK Z4 CONSTRUCTION NEW I ADDS ALTER REPAIR 1MOVING nFMOIISH M LENDER Xo_CO J n BRANCH gel. \/7 - J Vf OWNER r r1 H L�� m 1 ADDRESS (� ALOE 1,672 J OD ARCHITECT TEL. USE i $�� OR ENGINEER NO. ' L14 FIRE NdtAT Z ft ADDRESS ZONE T PE GROUP aJ i1 W APPROVED �(j(/_ 5----7..y.-767- _, � LU O CONTRACTOR () c-4...---,n., e'� -i' 1 alit— BY 0.— DATE J� .-7� • x J ca ADDRESS W co TEL. ZONE NO.OF USE OF NEW tl o_`�C ZF^ CITY NO. _ - W R( ( r/PLANS L BUILDING Jfr4 O STATE CITY YARDS APPROVED YARDS APPROVED cn 5 LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D / SIZE NO.OF BLDGS. (FROM CAL STREET). OF LOT p NOW ON LOT / RONT 33 Q- FT.-".-~ FT. USE OF EXISTING BLDG. /f /QE ✓ E / G R.SIDE FT L/ FT, Ir SIZE OF NO. OF /�' _ 11 2NEW BLDG. ROOMS STORIES L.SIDE rR// -. . FT. Ci EXTERIOR WALL 1 ROOF COV RING COVERING REAR FT. FT. J U CrBUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& GqLO e r- G�AL L Se--reAt'eRtc/L/ MAIN BLOCS.a ACCESS.BLOCS. Q (�/` /J �� VAR.# DATE 0 L O 775.. a 7 Xj(/Va, C.U.P.#p/ / p APPROVED / y/ Z /� ( / /ictr!l APPROVEKidt/ rf C DATE.5-IOf���J o (/Yil LfF�T�! a. U I hereby acknowledge that I have read this application and state D that the above information Is correct and agree to comply with CC all laws regulating building construction, and I shall not employ z H any person in violation of the workman's compensation laws of Wet V) the State of California. N. l�f'*e• 02 ? I hereby certify that I am properly licensed as a contractor under SO. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: S am exempt from the provisions of the State of California Business VALUATION �.S.--d m and Professions Code, Division ,Chap :r 9. PERMIT FEE $ j Signatur^.,,'/ / ,JJm Permittee" .0777/.41 ��A .r-i $ PLAN CHECK $ E 5� Authorized Agent LL TOTAL FEE $ CITY OF COSTA MESA 25422 '-- COSTA MESA BUILDING-SAFETY DEPARTMENT MAR 23 1966 , P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 z} of For Applicant to Fin In Completely RI. SI:r9 :•• 1 TYPE OR PRINT BUILDING BUILDING For Office Use Only ADDRESS 3109 Yukon Avenue .(,(p//�/T RECEIPT NO. PE95422 COSTA MESA. CALIFORNIA LL RRC[ BY oATE REC 7 DD ...D/,TE4 I Iy.0.t OWNER U.S. Financial 1 �// �ulu/{{11�i 0. MAIL BUILDING ADDRESS 1355 Front Street LOBE 1' /.ADDRESSFIRE / CITY San Diego, Calif. LOBE .96^041 ZONE TYPE (/ GROUP - APPROVED AoCTECT TE NGINEER A. S. Henrpck e03319h DY DATE ZONING / ADDRESS 12061 Santa Rosalia, Stanton EG / I :..... r.„.2 i D.E OP NEW YAC/Ky K BUILD , CONTRACTOR Lewis R. Schmid - , `H, ADDRESS 2940-A Randolph DESCRIPTION �1 4.0- /Ja. 44 7 l CITY Costa Mesa, Calif. A.P.NO. YJ"--- STATE TEL. 30"TO SIDEE: NO V RR OVERHANG SHALL BE LESS THAN LIC.NO. 2314399 NO. 540-96o EAVES SIZE I NOW ON LOT o ALLOWED (U.B.C.REQUIREMENT/ OFLOT 71.291 x 100.051 YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. ^(PROM C/A.ST ) SETBACK LINE FROM 1'(+ CENTER OF STREET 451 REAR YARD 30.291 FRONT FT. PT. 8108 YARD I LEFT 5 I I RIGHT 61 R.SIDE S---- FT. FT. DESCRIPTION OF WORK L.SIDE h PT. FT. CfY ALTERATIONI ADDITION REAR, • RT. DISTANCE BET. BET.MAIN D REPAIR _MOVING _DEMOLISH MAIN BLDG'', ACCESS.SLOGS. BUILDINQ r NO.OF VAR.# DATE SIZE j343.21 sqI ROOMS 5 STORIES 1 C.U.P.# APPROVED EXTERIOR WALL U ROOF Shakes and `APPROVE � �l! �"// .` COVERING Plavtrr COVERING >hjngle.9 BY 1DATB / USE OF BUILDING AND WORK TO BE PERFORMED h Single Family Dwelling with Attached t) / 9 Garage P 460471V-f� /34-3 SQ.FT. i I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. IMPOSE OF ESTABLISHING A PERMIT FEE ONLY. F17 PLY WITH ALL CITY ORDINANCES AND STATE LAWS RSGULATIN UATION OO /© BUILDING CON RIO �f ` PERMIT PE8 /F_ SIGNATURE OF -04c-r� // �� �, Li PERMP ��/7 . , ,,,„,,e, PLAN CHECK S �� 1i i AUTH 'ZED AGENT I �j O baanneplemarmanzcznasurran TOTAL FEE 5 7 APPLICATION FOR A BUILDING PERMIT _ Electrical CO BUILDING PERMIT NO. / C '� Tract / Block �✓ / Lot �/k Permit No. F , •) " C CI Building Plumbing -. Address ?Joe/ //d L,-1 �O (71 ^7 Permit No. //JI�.Q /// �� Cross i, • // Mechanical ✓, i7 6 Area 1 /�,c �r Street rY��t� Permit No. ././/// at Owner / /c r r L/< //'.1..." /�, Type of Project: ❑ New ❑ Alter IC] Addition Address, %/9 , ileIC /•Lin )� ❑ Repair ❑ Convert ❑Demo ❑ Occupancy Pmt. City(AC//,, !/C./� J/Ci Zip/ 4 Phones2//J•G A.P. — Sup.Dist./ Sup. Area Architect/ /� 7/4/� Zone SPI.Pmt.No. Designer OD/J/grit., t(- License No,C 42 11,12.‘"— / -� , f/1 Setbacks P/L Front C/L St. Street Width Atltlress `. / / // Yards Left Right Rear C It Y/14/:'rte/r71 / /4/)l ZIP9QbG/ Phoneei7 1C.i/ ✓ Lave Pror. Left Right F.N. Engineer License No. C Parking Spaces Required Provide Covered iqa Address m City Zip Phone Strutt No.of No.of Heightu Stories Family C LICENSED CONTRACTOR'S DECLARATION Park Fees ❑ Yes Fee co E I hereby affirm that I am licensed under provisions of Chapter 9 Required No C.T. Receipt t (commencing with Section 7000 of Division 3 of the Business and Zoning Approved By: Date Professions Code,and my license is in full force and effect). License ClascJ& EF'/9 lb-/n{ License/t��1�umbern- T Date g' - /G Contractor) .�4Z�/Y.CJl ldlr/24-i •7:-.C._ Misc. E Address Z GSC e/Cr7 ,+-� Proposed Use . 11J /• C."F /siGG/1i f"1�i'gneC 41/`2"7 rYu of Structure ',It City and Zip Cn _ H CONSTRUCTION LENDING AGENCY 1,2 I hereby affirm that there is a construction lending agency for the 9- performance of the work for which this permit is issued (Sec. 3097, OCC. Cone Code ' Civ.C.). '/ Class Const. Year to Lender's Name (1-14 / Pe U c Lender's Address C/2.5.71/4 i''riese USE/OCCUPANCY SIZE SQ.FT. :I OWNER-BUILDER DECLARATION y 1. I hereby affirm that I am exempt from the Contractor's Lie-• - aw m for the following reason: o ❑ I, as owner of the property, or my em. . .r with wages as their 2. sole compensation, will do tit- a , and the structure is not t intended or offered for . - a 3. ❑ I, as owner of - property, am exclusively contracting with licensed -`tors to construct the project. •• 0 1 :xempt under Sec. , B&PC for this reason 4• 0 a •ate Owner • Total Valuation E WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self-insure, Encroachment Permit Required ❑ Yes ❑ No or a certificate of Workers' Compensation Insurance, or a certified C copy thereof./ p T j /�� Grading Pmt. Grading 8 Policy No/O/'7/'I773Company,L1f Cis ."P'" /'4 S/ Required ❑Yes ❑No Pmt.No. 6 0 Certified copy is hereby furnis ed. Rough Grading Certi y is filed with t. -t„C"' Ci 7^. C.Alre Ceyp y / , , Approved by: Date Date / ss� Applica ./ jam"a" t/ 3 • CERTIFICATE OF EXEMPTIO ��>> / FROM WORKERS'COMPENSATION INSURANCE Z (This section need not be completed if permit is for $100 or less). C I certify that in the performance of the work for which this permit is S issued, I shall not employ any person in any manner so as to become CD Q► subject to tate Workers'Compensltion Laws of C ifornia //q PERMIT FEES 2 Date S?' — C ApplicantJ343fr/7-'144R4td11? -s/. rt NOTICE TO APPLICANT: If, after making this Certificate of Structural $ Plan Check S Exemption, you should become subject to the Workers'Compensation provisions of the Labor Code, Special you must forthwith comply with such. Electrical $ Invest. $ provisions or this permit shall be deemed revoked. A I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE Plumbing $ w: THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO V COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS * RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTH- Mechanical $ & ORIZE REPRESENTATIV OF THIS COUNTY TO ENTER UPON THE ABOVE' M NTI Co PROPERTY FOR INSPECTION PUR- Pre-Grade 1 POSES) ` Inspection $ leant -or /Agent J e-, ' Pre-Grade PermitL 7 Signature of Ap Agent DateRec.No. $ Issue $ i ,rh/J - i�ixa)s ea-7A,. .c/, &z //a- 6- Print Ap licant's/Agent's Name ,J--i All spaces within this box must be completed toprocess PlanhIssuance P P Check By: Approved: CMF 0335-46(BU-28)rev. 6/80