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Home My WebLink About3017 KILLYBROOKE LN - Building Permits PROJECT ADDRESS: 3017 KILLYBROOKE LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 069886 OWNER'S NAME: CITT ELL, DOROTHY E TR ADDRESS: 30177 AKILLYBROMESA,CA KE LN 92626 PERMIT NO; P 069886 PLAN CHECK NO: N GOVT: N S`UPP: N COSCONSTRUCTION TYPE: V—NR PERMIT TYPE: PLU PURPOSE: OTH 546-5229 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; INSTALL WATER HEATER SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: COAST VIEW PLUMBING ( 714 ) 957-4087 ADDRESS: 623 BROOKVIEW WY COMMENTS : WATER HEATER ONLY COSTA MESA CA 92626 **4(4.44*******************4r-4444**44-44*4444***4Fr+rlc--ugr-xaa*ac.ac*444444 raEvc44-443+-.y.x.as-leaf-wat*#-N-+c--1F4444.41-41-+h 444F- LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU I R EMENTS 7000)of Dwi 0 3 o th usiness and Prole ion s s a d my license is in full forc and effect. SETBACKS CITY LIC.: 4 b STATE LIG.: 1 4 e ums, 6 P: 0 2/9 5 / �/ Cy ter ' a MAIN BUILDING ACCESSORY BUILDING Da :�/.-Le — � Signature:__ i' ------ FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN RKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN Compensation i1wm82a7a3c6rtuie9r{4py thereof(Section 3803.Lab.LJ.9/01 /95 MOUND.: STATE FUND EXP.DATE: PARKING REQ: PROV; PARCEL; 14116213 ZNE: REF NO: COMPANY: ��(( PLANNING NOTES> 7 Certified copy is hereby furnished. L( Certified copy is h with the city Building D 'io > G. er 0 - 0- IApplicant: '/Y �/__7 DEVELOPMENT SERVICES REQUIREMENTS FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). I certify that in the permanence of the work for which this permit is issued.I shall not employ any person in any manner so as to become ZONING APPROVED B Y subject to the Workers'Compensation Laws of California. DATE Date: Signature: BUILDING APPROVED BY ; NOTICE:II.after making this declaration,you should became subject to the Workers'Compensation provisions of the Labor DATE Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. mo APPLICATION ISSUED B Y; 0 Lk CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for DATE; L I which this permit is issued(Section 3097.Civ.C). ************************************ ******************X'************* +F** ***********************************************-if4f******4f****************}+f***if* 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 fallowing 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 7 , 00 repair any structure.prior to its issuance.also requires the applicant far such permit to file a signed statement that he/she is licensed 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business P LAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 20 . 00 any applicant for a permit subjects the applicant toaCivil penalty of not more than five hundred dollars 135001. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the property m my employees with wages as their sole compensation, wit do the work, and the TOTALS----> 7 . 00 00 20 . 00 0 . 00 00 27 , 00 /� 27 , 00 . 00 ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Cade: The Contractors'State 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 employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED ; 27 . 00 OVER/SHORT : 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). 27 , 00 I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply lo 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 that proof of their Worker's Compensation insurance should be provided to me. IND IV IDUAL F E E BREAKDOWN O I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00 I do hereby certify that I am 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, Date: Applicant: herebyes and that I have read this application and state that the above information is correct. agree h comply with all city.and metoothy - ordinancesandstatelawsrelatingtobuildingconstructionandherebya 1 e representatives of this ci ter upon the above-mentioned property for inspection purposes. 01 00171491-00171491 TOT 2'7.0C / Da Q. //�[J ( / 164146 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POO. ;PA APPROVALS Permit# Date 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-Undrrgrnd. 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. 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 Drains64. 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 PREV. 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 Notes: 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test 36. Hood or Canopy 37, Final Factory Fireplace 38. Final Plumbing 2 1f C}. e 39. Water Service-Final 1 4 G-,- 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date r p w F 1 CITY OF.COSTA MESA 4 9 BUILDING DIVISION • > •q- r.-„z. t, DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F. r-s1.11..a / PERMIT 4'4,to�+' E06-00908 (714)754-5273' 0 • Fax(714)754-4856 • www.ci.costa-mesaLa.us tCTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: :3017- ?KILL'-YBROOKE°L-N` - Status: ISSUED Suite No Applied: 08/15/2006 Vicinity: - Issued: 08/15/2006 Parcel Nunmber: 14116213 Applicant: CITTELL, ROBERT Address: 1750 WHITTIER AV ISSUED BY: SUITE 13 Phone: 949-642-5872 COSTA MESA,CA Zip 92627 Owner: CITTELL, DOROTHY E TR Address 3017 KILLYBROOKE LN Phone: COSTA MESA,CA Zip: 92626 Contractor: OWNER-BUILDER Address: Phone: Zip: License:000000 - - SCOPE OF PERMIT UPGRADE ELECTRICAL PANEL TO 200 AMPS. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0- - up to 10 kva/kw $0.00' 0 Lighting Fixts $0.00 •0- up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 . 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res AppI - $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $30.50 1 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 . -.0.,. Christmas Tree Stand $0.00 0 Motors to 50hp • • $0.00: . 0.- Fireworks Stand . $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0, Communication drops $0.00 ' Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg . - $0.00 0. Reinspection Fee $0.00 Sign Circuits • $0.00 •0 • Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $54.00 Intermed Pole $0.00 0. COMMENTS /SPECIAL CONDITIONS q - - /D FeetA 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 l_ WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declaration&-" ❑ 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. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This s tion need not be completed if the permit is valued at one hundred dollars($100)or less.) .fcertify that in the performance of the work for whic this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Californ' and a ree that i ho becom sub' the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provision Applicant-Signature: :— WARNING:FAILURE TO SECURE WORKERS'COMPE SATI VERAGE IS UNLAWFUL ANDHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.N Class a Contractor's Signature: 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 subjec e 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: ntractors 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) lic e pursuant to the Contractors License Laws.)), • am exem der B e and Professions Code for this reason: • ignature:_. 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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LLI 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 ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE MD 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 o comply with all state laws and cit ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-descri-':prop- or in cti rpose /:•re=4A• 21.. or allow occupancy of any building authorized this permit until fees ection. Slgnatur OLLegal Owners - (Date_- And/Or Authorized Applicant Date CODES, INSPECTIONTPP6 DATE INTRIALS CODE II INSPECTION TYPE PLL INTMAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 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 _ 4UWNEtt HAIM:RES'1' PARK, INC. DA'L'E i-12—bt3 JOB ADDRESS 3107 Killybrooke Lane BUILDING PERMIT NO. 28288 GENERAL CONTRACTOR Harbor Cememt Works DESCRIPTION OF WORK Block Wall AP No. 111011-12 LOT 1 TRACT 1121 FIRE ZONE VALUE $a8?.00 \i INSPECTIONS Signature Date GROUP J TYPE TTI ZONE A_,¢ p Soil SUBCONTRACTORPERMITS ISSUED Gas I Date I Number I Signature Water Plumbing Rough Plumbing Prop. Swr. Line 0 House Con.�p Sprinkling System Miscellaneous Rough Healing and Air Conditioning Temporary Service or Pole Underground 0 Power p Rough Wiring Heating and Vent. _ Trenches 0 Forms 0 Steel Reinf. Q 1,e/0- Floor rkFloor System Bond Beam 0 Steel Reinforce 0 Sheathing _ Frame and Flashing Lathing—In 0 Out ❑ Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test ❑ _ Electric, Final I Building. Final I itt'] OWNER Crtl1ege Mesa Co. DATE 8-19-55 JOB ADDRESS 3017 KKllybrooke Lane BUILDING PERMIT NO. 1673 GENERAL CONTRACTOR The Hale Co. VALUE $ 8,000.00 LOT lb BLOCK TRACT 23141 Residence GROUP 1 TVP V ZONE R14 FIRE DISTRICT 91690 • PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR q d r DATE NUMBER Footing Trench /Lc-i/ -. •-.» Foundation Forms and Grade to GarageeQ6 _, a -/9` Rough Framing r d G—� - ; -I Plumbing, Rough to Slab �� -or n Plumbing,Rough Complete Na/# °mLa" ^. ZZ.L2 9-o - SS Y7 r/ Temporary Pole � //�� / Wiring, Rough o1JX'J 0-/7S ,t,....C.,...3...... 0.-ci . /!-7_rr /S-�/ Heating,Rough Heating,FI alii_ ,�:-y,.,- ? 9 % c7-/ � — /n ' 7 'S3 )(Sewer• e I li Sewer,St. OP Cyx� ea- a-023 SS" .3 i/63� Septic Tank o Cesspool d Lathing, In , -3 ' OutI , /9;724-A- Plastering ,15111, ^.5-- I Plumbing,Final,Fixtures Complete ,- -J 1 Plumbing,Final Gas Test ft /// ��/1 Wiring,Final '♦- { - a 4t- S% G rr" F r i - At Occupancy 7t. _ 3 .5"-re j Form 210 G-H 1500 1-55 Costa Mesa Building Department APPLICATION FOR PERMIT 5. 111 EAST 20th STREET - 1690 BUILDING 1 COSTA MESA, CALIFORNIA • " FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. Permit No. Building- /6' 73 Address 3017.8iltybrooke Lane Costa Mesa,California Received by Date Rec'd. Date Issued Nearest —�/ ��3� Cross St. Baker Street Building 7 ��6tir>2e Address �rT� � Owner College Mesa Company Costa Mesa, 2alifornia Mail Address 8002 Central Avenue Nearest O_ l/- , Tel. Cross St. c�l� City Garden Grove No. IE 9-2158 Zone p , /I No.of I Typ� Group T Architect or Lic. iC.. �7- Plans Engineer Davis & Quigley No. C-1790 Approved by Date Address 43 Malaga Cove Plaza,Palos VerdEs CORRECTIONS contractor The Hale Company No. Lic•3422 Address 8002 Central Ave. , Garden Grove Lega1Lot I Description I No. 14 Block Tract 2341 (Attach Metes and Bounds) I No.of Bldgs. Size of Lot 7Q28 Sq. Ft. I Now on Lot re Pa 10 Use of I No.of I No.of l�'� xi Existing Bldg. Families Rooms - Setback Line from Rear Yard 4S' )1IJ a 19 1955 2 Center of Street 50' Side Yard 7 i y DESCRIPTION OF WORKr — New I X I Alteration I I Addition I CITY OF COSTA. MESA Repair I I Moving I I Demolish I ,, . • • Building No.of Size 1181 Rooms 5 Stories 1 Exterior Wall Roof Covering Stucco Covering Rock APPROVALS Use of New Building Single family dwelling with Foundation Location Inspector Date Forms,Materials, attached garage. Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath.Int. with all City Ordinances and State Laws regulating building construction. Lath.Ext. Signature of THE HALFrCOMPANY Permittee - i • Plaster,Int. Authorized Agt. _ / a— , i -„Sr A ,Plaster,Ext. erman . _ Valuation /.. Permit Fee $ ', I aC Masonry Reinforced _ - /e •�i�i Plan Check $ s,I `3 Bond Beam $ 43 .6 iLl �_--s FeeTotal $ ''� ' FINAL FOAM 204 S-ap 2M 0.55 Ar 1 m s c v l ' • - J 5 o d a a` ros"rn' 'WI; 1 9-55 PUiw A -9332` vrt *n7,3j.Q S.." Street -_4 . PLOT PLAN Show location and distances fromproperty line and between buildings. _ F . . . ,I M. OWNER CITTEILL, J. DATE 8_18-78 JOB ADDRESS 3017 Killeybrook Lane BUILDING PERMIT NO. 46575 GENERAL CONTRACTOR Custom Commercial IGDESCRIPTIONofWORK RnolnsPd Patin Cover AP No. 141-162-1.3 LOT 14 TRACT 2:47 FIRE ZONE VALUES 1,250.00 INSPECTIONS Signature Data ,TYPE Di GROUP JZONE R-1 SOIL SUBCONTRACTOR PERMITS !SR.ED AS Date I Number Sign }}}NATER Plumbing OUGH PLUMBING ROP. SWR. LINE II HOUSE CON. 9 SPRINKLING SYSTEM )MISCELLANEOUS OUCH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE 1 UNDERGROUND 9 POWER 9 OUGH WIRING _ f ' HOatina and Vent. TRENCHES t� FORMS Li STEEL REINF. 0 FLOOR SYSTEM BOND BEAM J, STEEL REINFORCE rl SHEATHING FRAME AND FLASHING LATHING - IN n OUT 9 PLASTER. BROWN COAT STRUCTURAL, FINAL Electric HEATING. VENT.. REFRIG. AND A.C., FINAL PLUMBING. FINAL AND GAS TEST 9 ELECTRIC, FINAL i b.79,72.- BUILDING, FINAL 4;575 COSTA MESA BUILDING-SAFETY DEPARTMENT 3328 8/ 18/78 20.00 TL" P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 .1 ,t1.? APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Co• pletely— U • Ink OnI 7...0RECE �1 DATE RECEIVED . BUILDING ADDRESSaitilirMita / OWNERf L _ 11 A.P. NO. / 7 I �I - 2 — 4 PERMIT NO. . ADDRESS�� ` BUILDING \� , ` 11 ill ADDRESS 'Ate TEL. CITY NO. TRACT 2 3V1 LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI1SH LENDER BRANCH ........••• • ` ` I OWNER _ n//,/� . OR ENGINEEARCHITECTR/�(� l�� VP NO. USE ff,„, a VS E /.>I{./�(/� vvvv FIRE ADDRESS • ZONE s J TYPE GROUP/. J�/L CONTRACT/O_ APPROVED DATE�f7�1(/ ADDRESS I/\8 ,S u ` /'►x"`444+++ us / ZONE NO.OF • USE OF NEW TEL CITY/" \�_ t s NO.1_� (0Ih RI PLANS BUILDING STAT O. `•�� CITY YYY»> YARDS APPROVEDMAIN YARDS APPROVED F / /� LIC.NO. 3 sem\ �. LIC. NO�/ �J (FROM C/L S BUILDING ACCESSORY BUILDING W SIZE JJ YY ` NO.OF BLOCS, L OF LOT 6V x r&D NOWON LOT FRONTFT. USE OF ((�� ((��)j19EXISTING BLDG. '�J( 0 R.SIDE 3 • FT. ° FT. CA '` F U Separate permits are required for L,SIDE 5. FT. FT. electric,plumbing and heating work. REAR /.r FT. 0 FT. IQ [.. US- OF BUILDIN •ND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 'etQ a � ` _- - _ - _I_`= MAIN BLOCS. ACCESS.BLDGS. VAR.# DATE Q S rirc -e w S / 7 I ,k • - ea..„ \ C.U.P.# APPROVED / K'�C�Y A ` \ ROVEDG1wIt 14 DATE 6"-/ 7[70 y CC IY 0 I hereby acknowledge that I have read this application and state tn N N Cd that the above information is correct and agree to comply with O m all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of e W the State of California. I hereby certify that I am properly licensed as a contractor under 19 SQ.FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force an• :ffect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: m am exempt from the provisigns of the State of Calif la Business VALUATION PERMIT FEE $/ cr and Professi• s.ode, •' 'siorl 3,Chapter 9. 3.00 Ji Signature of ` �� 1 / C 00 PLAN CHECK $ / 5� a Permittee _ j_. $12.J O TAX $sip s fl •U Authorized Agent ' TOTAL PAID s/O .00