HomeMy WebLinkAbout3138 KILLYBROOKE LN - Building Permits ADDRESS OF 111.110010: 3138 KILLYBROOKE LN DMT: CITY OF COSTA MESA - BUILDING PERMIT
OWNERSNMIEIRffNDwN: VALENCIA, MICHAEL L FLOOD: X 46 PERM NO: IB 084934
ADDRESS` 3138 KILLYBROOKE LN
COSTA MESA,CA 92626 PERMIT NO: IB 084934 PLAN CHECK NO: N GOVT: N SUPP : Y
AP PL.MAILING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: OTH STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UGNO. JOB DESCRIPTION : T/O & RESHEATH INSTALL COMP. SHINGLES SQ FT:
ARCN.OR ENC.'S ADDRESS: DMT:
CLAIM VALUE: CALL-VALUE: GROUP OCC: R-3 /U-1
DDtJORACTOWSNANE' ULTRA LITE ROOFING ( 714 ) 899-9935
CONTRACTORS MARINO 5082 BOLSA ST COMMENTS: SMOKE DETECTORS ARE REQUIRED
ADDRESS: H.B . CA LIC.fa.: 616679 ************************************************************* ;E*****1E*3E-xiE3f4Eif***
92649 OMT. 105 Z ON ING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby robin under penally of perjury that I am licensed under provisions of Chaise.9 SETBACK S
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full face and effect.
NO.:051082
UC.CLASS: C_39 uc.No. 1 -• " ' EXP : 03/98 MAIN BUILDING ACCESSORY BUILDING
o� „� �,�� FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
079 /�
Contractor: = �N �" LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
• � 'ER BUILDER DECLARATION:I hereby affirm under panty of perry I am exempt from the Contractors License Law for the
dbwkgreason(Bathos7o3T5Bueneesand ealsoCoda:Anycppacountywhimcoquinasapmmnto staetmetoder,bnprove. PARKING REQ: PROV: PARCEL: 14102220 ZNE: REF NO:
demolish,or repair any structure,prior to its issuance,t also requires the eppli,ant for euch peng Io file a maned statement Ihal he or she
is licensed pursuant to the provisions d the she is License Law(Chapter 9(commencing with Sem pit 7000)d Division 3 eof the PLANNING N TES>
Business and Professions Code]or the)he or she a 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 mil penally dot nmore than five hundred dollars(SSDOD. x 1( 1( N % N % % % % % % %.%!% % % % N N N % N % % % N % % % N % % N % % % % N X % % N N N % %% %,%.A" y'
❑ I.m owner d the prosody or my employees with wages as their sole compensation,will do the work,and the stridor•a rat lntendnd 1E E f** dE"d •* y. }.* :» .*y y{ ....� .*»*' yK� (may *».�s� * * E) kh� ***** # } ***
or offered for sale(Section 7044.Business and Profession Code:The COntradors License Law does not appy to an owner d property 8 G G • L%� 1'7 ' G IV 1 t"*1�Kw "*1 'L C S I( U I R E M E N T' S
who builds or improves thereon,end who does such work Nmeelf or herself or through his or her own employees,provided that such �!
improvements are rot intended or offered for sale.N,however,the building or inproement'e sold within one year d completion,the
wner-builderwtthave the burden oproving heorshe dinot buikaimprove for the purpose ofsale). ZONING APPROVED BY : DATE:
❑ I,as owner of the property,am exclusively nontrading with licensed contractors to construct the project(Section 7044,Business and 1
Professions Cods:The Contractors License Law does not apply to an owns of properly who builds or improves thereon and who BUILDING APPROVED BY : / DATE:
contracts for such prgeds with a caNrmaor(s)licensed pursuant to the Contractors License Law). • -
❑ I am exempt under Section: B.AP.C.,for this reaem: APPLICATION ISSUED BY: �/1/1 a�� DATE: �q _
Date: Owner: ******************************* W /[an. * ,f*******sf*se,E,c********** 7r * **
I do hereby certify that lam aware of end understand the requirements of California Health end Safety Code Sections 25505.25533,and LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
25534.end that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for
apemmnforconimdionormoddtmtanfrom the AiaisaiyMaanagement District.Reekagiel construction applications ere esa pt from ase BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 42 . 00
Data: Applicant: SM I P/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one d Ilefollowing dedanmbn: PLAN
❑ Ihave end*II mamain aceddieme d consent lo self-insure lerpesed
r worke 'comnion,as presided for by Section 3700 of the labs ISSUE FEE
Code,forthepedamanceolthewakforwNmthispermitisissued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
o lhave end will maintain workers'compensation inwrence.asrequbedbySedion3700dthe Labor Code.for the pedamanceothe TOTALS----> 42 . 00 0 . 00 0. 00 42 . 00 42 . 00 . 00
work for which this permit is issued.My workers'compensation insurance carder and policy number are:
Carder: aflr.nPN FAGT,F EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 42 . 00 OVER/SHORT: . 00
Policy Number: Nwr7F'A7R-02 06/13/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING ;PLAN-CHECK
(This section need not be competed I the pend is for one hundred dollars($100)or lees.) 42 . 00
I ear*that in the performance o the work for which this permit is issued - note,-••'any pawn In any manner•o an to
,became eubpd to the workers'compensation)awe d California ep.. Nal '. M .aei . subject lathe workers' *******************************************************************************
dimpenembn• • Bacton 3700 d ihe Labor Cods. .. with�...�A .C.=
Ume- - _ Applicant: / '( IND I V IDUAL F E E BR EAKDO 14 N
We g:Fail•rsfos re workers'contposadoncoverage leunlnNN adshall subject anemployer totrim/net penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
fines W to one hundred thousand dollars(SI04000),In eddidon '. the cost or compensation,damages as provided for In
Section 3705orthe LaborCode Interest,and eDOmeysfees. INS 1 BUILDING RE-INSPECTION FEE 42 . 00 42 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under Pommy of perjury that there is•construction landing agenty for the END OF FEES
performance of the end for which the permit a awed(Section 3097,Civ,C),
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read this application end pate that the above information is corral.I agree to corn• -city and county ordinances
end state laws relating to building conwudion and hereby authorize representatives of this dry to ent: .. a above-mentioned propend
s for inpedlon purposes.
r Q I� �� 83 2 1997/.3:_': r,:/i4E.0
s inure of Owner/AgenttApplcanuContrador
(5151-46 WP) White-Building A Sway:Green-Al:Canary-Appimnt:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL & SPA "
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
•
2. Soil Pipe-Undrgrnd. 1 ' 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 i
6._ Electrical UFER-G�nd. 57, APPROVAL TO COVER-GUNITE 1
`7:-Footings • 58. Electrical Conduit-Undrgrnd. t
. ':B: Foundation - ? 59. Gas Pipe, 0 Uriclrgrnd., Test
.. '9: Water Pipe-Undrgrnd. - 60. Backwash Lines,'P-Trap, 0 Undrgrnd.
710:- 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 & Acces
- _ s Approval •
17. Rough Wiring Sign - 68. APPROVED FO-Fk PLASTNING
18. Rough Electrical`T Bar Ceiling- ' 69. POOL/SPA SYSTEMS FINAL
19, Rough Heating & Air Conditioning 'FIRE DEPT.REOUItjEMENT
} .. _
20. Rough Factory:Fir1fflace _ Av # APPROVALS_ Permit# I
21. Ducts-, in Structure' •• •• - y - , ~r 70. Vndergrourid Hydro
22. Ducts, Ventilating.; - _ - '1 1. t ' : 71. Product Piping D Gas D Oil
•
23. Gas Pipe-Rough & Test I >_: S : t 1 72. Underground Ftdsis ' r •
24. Roof Framing ' , -
.i r •'- ' ' t : 73 Undergrrid.Stoiage tank.D Gas D Oil
25. Roof Sheathing .; r______= 1/3;19 .7
I - 9 74i•Overhead Hydro . . r
Ceiling 26. T-Bar (Structpral) & Md2iopoat I ', - 3 ! 75. Dry Chemical _
27. Frame and ' -
Flashing' r- _ 76. Dry Standpipe �'- _
28. Lathing & Siding _ - "' t 77. FIXED SYSTEiG1 FINAE _,
29. Insulation •• 1 78: FIRE PREY. FINAL -1.
30. Drywall (failing ....- 4.,t _, , HEALTH DEPT.REQUIREMENT
s 31. Plaster BEown-Coat r. - ri, 4 79. FINAL INSPECTION -
F 32. Electrical-Power Meter-Final C` I� • 180. FOOD CERTIFICATE ISSUED
33. Final.Electric - 4' r Notes: n
e T „
34. FinarHeating & Air Conditioning - r 4: ,
35. Final Gas-PiPe7Test t - .• •
. T.
36. 1-4 C. Canopy - - t
37. Final.Factory Fireplace _ - . - r
•38. Final Plumbing '
t
39. Watei Ser,'vice-Final . - _ t t
40. Gas Service-Final ' •
- V;
=41. Solar Domestic-Fina( s 1. -
- 42. Backflow Preventer • . - • -
43. Backflow Irrigation , , - : -
44. Landscape Irrigation•System - - •
. . . • r
45. Sound Attenuation ; ', „ - ,; `. - - ,t�
46. Handicap Regulations //-- -,�- )+ " -_ '
47, FINAL STRUCTURE & BUILDING /L5�7 i}l'4Q �p L�vl ,
48. FINAL PLANNING _ - -1
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co - ' •
51. CERTIFICATE OF OCCUPANCY - .
No. Date
ADDRESS OF OWING: 3138 KILLYBROOKE LN WIT: CITY OF COSTA MESA - BUILDING PERMIT
OMER'SHAREM MOAN: VALENCIA, MICHAEL L FLOOD: X 46 LFBM Nil• R 08473i
•`ke
it Ess: 3138 KILLYBROOHE LN
COSTA MESA,CA 92626 PERMIT NO: B 084730 PLAN CHECK NO: N GOVT: N SUPP : N
aPPL.MAIUNO ADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT ORENGNEER: UC NO,: JOB DESCRIPTION : T/O & RESHEATH INSTALL COMP . SHINGLES SQ FT: 8 , 000
MCN,OR ENG.'S ADDRESS: WIT:
CLAIM VALUE: 8, 000 , 00 CALC-VALUE: 8, 000 . 00 GROUP OCC: R-3 /U-1
CONTRACTOR'S NAME: ULTRA LITE ROOFING ( 714 ) 899-9935
CONTRACTORSMA/NG 5082 BOLSA ST COMMENTS : SMOKE DETECTORS ARE REQUIRED
ADDRESS: H.B . CA u"1: 616679 *ier.icirificiciEiciciiifitiFiideiciciiieiciiicieicieicieit3iiciiiEiritifiEiricicrtififir+FiciErcieiiieiticiiicv(-ifiiieiciriric+illiliiitiilocifit-xiriEiiR
92649 um: 105 ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under dovmims of Chapter S SETBACK S
(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and died.
C .NO,: LIC.CLASS: UC.NO.:
051082 C 39 616679 F�21P 03/58 MAIN BUILDING ACCESSORY BUILDING
ores `1�Ib10.-n co.... Ul �Pow—L3T£ ( SLI FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
OWN BUILDER DECLARATION:Ihereby affirm under penalyofperjurythaIamexempt horn the Controtlas • the LEFT: FT
IN kGHT: FT IN LEFT; FT IN RGHT: FT _ IN
Id ' reason(Section 7031.5 Buskess and Professions Code:Any city a county Medi requires a permit to mrutruct,alter,improve,
emolnh,or repair any structure,prior to its issuance,also requires the applicant for etch permit tofibeeyned statement that heashe PARKING REQ: PROV: PARCEL: 14102220 INE: REF NO: r
is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 700)of Division 3 of the PLANNING N V T E S>
Business and Professions Codel or that he or she is exempt therehom and the basis la the alleged eaempinn,My violation of Sedon >
7031.5 by any applicant for a permit subjects the applicant toe civil penalty of not more than free hundred dabs(55007). ....... ...... ... ..... ... ...... ... ... -
.,.., ...... .w... ...
RRx)tRRRjt'ie ill 31.it xiexxie ie x3txx+f it R'1Tzjc%t•xx]1.•It T"k jtkxzff ftzz'll•Yt'!f T'l1.'T'R]t f('/t'1l•1t'lFlt]l'Jt'1tT'It]t'lt"R fl Rill)f?E'RSiFffE ilR if i!
❑ I,asoerefdale procerin 7 my Bmaveiloessins Cothee sole Contractors License
cense the work,es nodpthe ytora O nerd intended
or who
dfor orWproves thereon.and
Businessandtuk Professions Code:The Law or he not emplytemown«of hatsuM DEVELOPMENT SERVICES R E Q 1J I R E M E N %1 S
Wideorie a non ted,and wed does such workw himself or herself or through e i herown employees, of comp then suche
o'omen-bider ere not intended hbur ora offered in sale.r however,the building or veprwere pit p sold within one year of oompleten,1.M '
versee-builder will have the iota«,dpmvnghe«she did not build or improve for the Purpoaedmb). ZONING APPROVED BY DATE: •
o L ss ower d the property.am exdusiveN contracting with licensed contractors to construct the project(Section 7044.Business and DATE:
_ _ _ _//_
Professions d pro
Code:The Contractors License Law does not apply to an owner property W110 builds or improves thereon end who BUILDING APPROVED BY :
contracts for such projewith a contractors)licensed Pursuant to the Contractors License Law). '
Minds
_
❑ l amexempt under Section: B.S PA,lorlhi reason: APPLICATION ISSUED BY: Ii DATE:
Date: Owner: It>rx** I**x'+i-id*ieie.iv it wleieif iexx xwetstxr3ex Ifs x xx Rzri z= r n len*if z4x*RRrx zzt a is a to is ill ifIa x1e�T WS.� ff 1
I do hereby certify,that l an aware of and understand the requirementsof California
Health and Safety Code Sections 25505,25533,are LEGALIZATZON:N F E E SUMMARY STRUCTURAL SEl"..vfENT:"Y'
25534,and that I or any future building ooapant will/wit not(circle one)need to comply will said slate codes and IM requirements fa
a permit for construction or modlficalionhomlhe Airt I0;anagement District Residential construction applicatiemaxeexempt from then BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/RES GRADING
provision.. PERMIT 137 . 25 •. . 80
Date: Applicant: L
PLAN SMIP/NON-RES
WO KER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE
I have and will maintain a certificate of=inn'to eetfinsure for workers'compensation,as provided for by Section 3700 of the Labor
Code,forthperformacedmeworkforwhichthispermiisisued. BUILDING DIV > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Ihave end veil maintain wodwre'compenaationinsurance,as resided by Section s700dNe Labor Code,tor the pedmmrroedtM TOTALS----> 138 , 05 0. 00 :4.. 00 138 . 05 138 , 05 • 00
work for which this permit is issued.My workers compensation insurance carrier and policy number are:'
Ceder: .•'Tr,nhi ane"_Tr EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 138. 05 OVER/SHORT: , 00
Policy Number re,,'MT
06/13/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP%1GT GRADING PLAN-CHECK
"s section need nor be completed l the permit n for one hunsp a dollars/51001 a less) 137. 25 . 80
• I testy that in the performance of the work for which this permit is neued,I shall not employ any person in any manner so as to ' "
subject to IM workers'compensation laws d California, and ay"that' ehae become subject to 1.M workers'
• pensatnn pmVgen ofSedion 3700 d the Labor Code,I shed forthwith those provisions.( . Mgr F+tres to secure woAsn'rompawtlon rovsr+Aoaunlawful,and shell subject o to criminal penalties sea 1. Rsxx39J3 !xx Rxxf Rf xcxxRx RRRRxxx RTxf FiR SR.
XF f FEx xR'kR Rx9f F f fx xxxx
xxxf Exx3fRRx] cx R9:
TYPE QTY INUIVZDUAL
DESCRIPTI' GN FeE BREAKDOWN
UNIT COST TOTAL COST
c v11 fines op to one hardred thousand do//n($004,000).is addition to the cost of co db as provided for In
Section 3706 of the Labor Code,Interest,and attorneys feet SFR 8000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 8, 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is e construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
A,
I cenify that I have read this application and state that the above information is coned.I agree to comply with at Sty and county ordinances
and sate laws rebtip to beading construction and hereby authorize representatives of this dry to enter upon the above-mentioned property z--
for inspection Purposes. ,•`'` 119-16-1997/E4:(35 Pd/$136.U3
LAURA KING •
�' /cit Name N FeE �T RCPT#:J1-uu12263
/s A Ca y I l In ICi') /:. j w 08473€,1
Signature. Owner/-..j . UC mtr:.a
(5151 s0.WP) White-Building 8 Safely;Glen-Fla;Camry-Appkrant:Pink-Revenue:Goldenrod-Assessor
V
I, CONSTRUCTION AND PLANNING POOL & SPA
•
APPROVALS Permit# • Date Inspector APPROVALS Permit# Date Inspector
!'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, O Undrgrnd,
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62, Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final •
-
15. Rough Electrical-Conduit. 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING.
18. Rough Electrical-T Bar Ceiling '69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning -- • FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts,Ventilating 71. Product Piping L 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. 7-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 //JJ k //
33. Final Electric Notes: 9/4Y7 / '��t4' .� W
f/G , //.Cly �.
34. Final Heating& Air Conditioning G �
/
35. Final Gas Pipe-Test ZZ• /7 ;4 Na r /a.
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 II 13
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co r' "� •
51. CERTIFICATE OF OCCUPANCY -
No. Date
Un "^ VALENCTA. Michael L. UMIE 3-4-76
JOB ADDRESS 3138 Kil ybrooke Lane BUILDING PERMIT NO. 41376
itGENERAL CONTRACTOR owner/Bid, DESCRIPTION of WORK Rlnrkwal l
AP No. 141-022-22 LOT TRACT FIRE ZONE VALUE 372n on
NSPECTIONS Signature Date TYPE III GROUP I ZONE R-1
,�SOIL PERMITS ISSUED
J GAS SUBCONTRACTOR
Date Number l Signature
iWATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE CON. fl
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND [J^ POWER ❑
ROUGH WIRINGHeating and Vent. .
TRENCHES'—.FORMS STEEL REINF. A. V/h ly(
FLOOR SYSTEM - /'"
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING — IN n OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING. FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL , Ric L+"5 ) . .
41376PAID
'OR -4-7Gcws.00 217* *****8.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APP IC N FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely - Use Ink Only gTjE y"q�/�0{�
j ' 1-13
REC I E Dom/ % /O� DATE—lte- ‘
BUILDING ) 3 c(//� /BOO //_� `/
ADDR ESS ✓� O,{ /' J � .L♦�J� �C [,�I �rl/ �JI F'p/�A/T/ys
OWNER / c////G� £. ZZci /2/vc/♦o A.P.NO, t 1 \—oZL--2 —I PTfi✓ 4
MAIL
BUILDING 3138 C
ADDRESS SA�Q ADDRESS Q ILLYBR.oCK.�� .
CITY 0oS//9 measff TEL.
NO. 67///29 TRACT {.] LOT35 BLOCK
CONSTRUCTION NEW ADD ALTER REPAIRMOVING DFMOLICH
LENDER
s
BRANCH
OWN/74117
N
h4feezmi
ADDRESS VALUEE %to
ARCHITECT TEL. VSE O(V
OR ENGINEER NO.
FIRE
ADDRESS ZONE YPE GROUP
/��—����A/J/_ r e APPROVED .yf./_ /
!/,`CONTRALTO BV DATE. /
ADDRESS
TEL. ZD
N -NO.OF USE OF NEW/
CITY NO. 1 PLANS C,..— BUILDING G fes/ a� /./-
,E .
-. STATE CITY YARDS APPROVED YARDS APPROVED IGsR��-
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
PA SIZE NO.OF BLDGS. (FROM CuL STREET) �7
O /. OF LOT NOW ON LOT FRONT FT. SFT.
USE OF
y EXISTING BLDG.
R.SIOF _FT. el FT.
C/1
FSeparate permits are required for L,SIDE FT. --les FT.
electric,plumbing and heating work.
Leal REAR FT. —43.--. FT.
E., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q _/ ♦ MAIN BLDGS. ACCESS.BLDGS.
CI.-1 VAR.# DATE
Q (, tf / .. L�V ([/SMij / ✓ t. C.U.P.vW APPROVED _�/s
> —APPROVE l� , DATE IAV / Cb
V LN'�LI�J f/
..i
a
w
oI hereby acknowledge that I have read this application and state 'n
Ce that the above Information is correct and agree to comply with m
0+ all laws regulating building construction, and I shall not employ
.Z any parson In violation of the workman's compensation laws of
W the State of California.
I 91D,-�
I hereby certify that I am properly licensed as a contractor under D D FT. a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR at
Chapter 9, end that such licenses are in full force end effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F SLI:
am exempt from the provisions of the State of California Business to
VALUATION PERMIT FEE $
and Professions Code,Division 3,Chapter 9. n
Signature o / PLAN CHECK $ 1e
t ///� �/ /f/)nto
Permittee V1AGf'47/4-` v $ /1�10/Y// TAX $ !� U.
//tt 7
U
Authorized Agent ,. TOTAL PAID $
OWNER HARBOR HALL OF FAME HOMES, INC. . DATE DEC"1 1 1962
JOB ADDRESS 3138 Killybrooke Lane BUILDING PERMIT NO. 9 MI11w
GENERAL CONTRACTOR Lifetime Res.Bll-g7-Corp. VALUE $ 1"1,41>.OU
AP No. LOT 35 TRACT 4355 FIRE ZONE DESCRIPTION OF WORKReS.w/att.Gar.
INSPECTIONS Signaau`re DATE GROUI'r TYPE ZONE
Soil EV/ /,./��7 PERMITS ISSUED
Gas r ' /_/7-C3
SUBCONTRACTOR DATE NUMBER
Water Li/ a-f.ti
Rough Corn. Refrig. 0 Air Cond. 0 _
Rough Heating ,f�al _Q-_� ,2_-.±71-4.2___ &
Rough Plumbing ,Z u� 3'x .9_ - _ _ _ a`&fC/, 47_Le12_ .573 _-_ Q,
Miscellaneous , ll, A'
Prop.Swr.Line ❑ House Con.$ St.Swr. ❑via 7-�3'!'!l3 / at,td U. -�/c-�,' 35:22/
Sprinkling System 0
Construction Pole ii1$'i9
Underground 0 Power 0 _�/ -3-75-43-1-f
Rough Wiring ;4/7 377(3 C"227LA],�/lr/ e. - 5 —
Trenches [.y Forms lir- Steel Rend. ❑ 'ij�/ /1..-2C-C2.-
Floor
%-2C-C1Floor System ,ir /-/C-6 j
Bond Beam ❑ Steel Reinforce 0
Sheathing 'i2' s'
Frame and Flashing Ir
Lathing — In p' Out Q— KTe ze--%-0
Plaster, brown coat ti it .5"---0-J-5:
Refrig. 0 Air Cond. 0 Final
Heating, Final L' -C ;!...-.24. 3
Plumbing Fixtures, Final -n-Gf
W7u4t7 FE RECEIVED
COSTA MESA BUILDING•SAFETY DEPARTMENT Lot 35, Tract 45, Ua.n 600-A
P. O. BOX 517 COSTA MESA. CALIFORNIA YCC 1.1 M. 12
FINANCE DEPT.
For Applicant to Fill In Completely . APPLICATION,'FOR e; asiTMESA
TYPE OR PRINT BUILDING
tir c"
ADDRESS
30p /1 / //k it t_ /1 a .2 J4,.._ ; _...._... .....:.:..�......__..___:__._ •'a
COSTA MESA. CALIFORNIA For Office Use Only
Inc, I RECEIPT NO. �PEBMI$ i7
OWNER Harbor Hall of Fame Homes, I��j41
MAIL RECEIVED BY 1 DATE ECEyVED DATE ISSUED
ADDRESS P.O. Box 2066- ,_o �.///-, /6 - DEC 1 1 196?
TEL-
� 11 BUILDING
CITY Santa Ana NoKI 9-220'1 ADDRESS '
ARCHITECT TE COSTA MESA. CALIFORNIA
OR ENGINEER Jamison NO 44-0040
ADDRESS 225 1111t1 St., Tustin, Calif. FIRE . crrl
ZONE „,///TYPE Yom' GROUP
CONTRACTOR Lifetime Residential Bldg Corr BYPROVED DATE
ADDRESS 2131 So. Artesia ZONING
CITY Santa Ana.
ZONE I NO.OF e. I USEOF NEW nq 94,.
/1J PLANS BUILDINGIy 4(9
41 94,.
LIC TIJD. 208676 NOITC2 9-2204 EBCHIPTION Lot 3S' 7�f' Nis..
SIZE NO. OF BLOCS,
LOT 6000' NOW ON LOT O A.P.NO.
USE OF YARDS ( EVES
EXISTING BLDG. "None APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.)
CENTER OF STREET 54' REAR YARD 27 6f1 FRONT .` 9 FT. ---
IN.
llr7
SIDE YARD I LEFT
' I RIGHT I R.SIDE FT. IN.
DESCRIPTION OF WORK - L.SIDE / 3 FT. IN.
NEW I X II ALTERATION I II ADDITION I REAR 2 7 FT. C IN.
REPAIR I D MOVING I II DEMOLISH I BBYPROVED /-",�� DATE /��//%�
NO. OF
SIZE iBUILE DING 6441 ROOMS 9 STORIES 2EXTERIOR �V"`
LL ROOF •
OVERINGWAPlaster I COVERING Shake
USE OF BUILDING AND WORK TO BE PERFORMED •
Single family r sidence
li(r/a `L /� /, /f
/ t-i --//3641 //v J6) ai
I HEREBY ACKNOWLEDGE HAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VATI
” ON IS FOR THE
AND STATE THAT THE A'• E IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING PERMIT FEE ONLY.
PLY WITH ALL CITY NOES AND ATE LAWS REGULATING
BUILDING COWMEN]. '(�I VALUATION
SIGNATURE OF ( • A/ �-_, PERMIT FEE $ .5-, N
PERMITTEF • 1 �1 ,
$ /`i][/3-4 PLAN CHECK $,--,,,3--a `µ
AUTHORIZED AGENT /J y/,�-- TOTAL FEE $ i/ •/iJ C� i