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Home My WebLink About913 LOMBARD CT - Building PermitsPN4ECT AU�flE55: 91 3 LOMBARD CT � OWNEH'S NAME: ROBERTSON, JAMES A nooaess: ROBERTSON, STEPHANIE R 413 LOMBARD CT COSTA MESA,CA 92626 RflCHIENGINEEH: AO�flESS: flEG.NO.: uxiT: UNIT: PEHMITTEE: BILT—WELL ROOF AND MA1'ERI ( 714 ) 739-1288 aooAess: 3310 VERDUGO ROAD LOS ANGELES CA 90Q65 UCENSED CONTBACTOB UECLAXATION: I here�y affirm [ha� I am litens¢tl untler prOvi5ion5 of C�aO�er 9 �COmmenCing with Set�ion 7000) oi Oivlsion 3 of Ihe Business antl Pmfessions Cotle. anJ my license is in full lorce and ef�ecl. cirruc.: 0?9076'/�sraTeuc.:q58005 ��S _r 39 EXP; OS/95 Date 7/��/D y Signature. �' �� WOPREflS' COMPENSFTION OEClAPA710N: I hereby affir a cendicale of consent to selbinsure or a ce�ificate of Workers' Compensation Insurance ar a rerlified copy ihereof (Section 00, LaD. C). voucrNo.: W937102489 E%P.DATE: O%/I3/9'S comraer: CAL COMP � Certified copy is hereby tumis�ed. 0. Cehi�ietl copy is �iletl wi�h �he ciry Building Division. �a�e: ApplicanC E%EMPTIONFflOMWOflKEPS'COMPENSATIONOECIANRTION: Q�i55¢C�ionneeOnolEetomplete0if�hepermilistoron¢�uMrea(5100)OrIe55�. I cetli�y thai in Ine peAormance of Ihe woB tor which t�is permit i ceee II not qloy any person in any manner sa as to hecome su�leq to the Work rs' C mpensa�ion Laws ol CaliPomia �J� Date: Signamre / �' NOTICE: II, alier making Ihis declaration, you shoultl sublen m Ihe Workers' Compensation pmvisions of �he La6or Code. you must lonhwilh comDly with such pmvisions or ihis permit snall be Oeemed revoketl. CONSiPUCTION LENDING AGENCV: I here6y aifirm Ihat there is a consimction lending agency for ihe performance oi t�e work lor which Ihis permil is i=sued (Seciion 3097, Civ. C). LENOEN: PDONESS: oWNEF 6WLOEP oECLaflpTION: I nereby affirm ihat I am exempt from the Coniraclors' State License Law for ihe follawinA reason (Semion 7031.5 Business anU Professional Code: Any ci�y of county which requires a permit to conS�mcL alter, improve, tlemolish, or repair any s�mclure, prior to its issuance, alsa requires the aDPlicanl for such Oermi� �o file a signeU statemen� Ihat helshe is licensetl pursuamtolhe pmvisions oilhe Conlractors' Slale License Law�C�apter9�commencing wilh Section 7000)ot�ivision 3 o�the Business and Pmlessions Cotle) or Ihat he/5he is exempl �here�mm anJ the hasis for �he allege0 exemp�ion. Any violation a� Section 7031.5 by any applicani lor a permi� Subleci5 �he applican� to a civil penalry o� nol more ��an live huntlred tlollars (E500). I, as owner a� ��e pmpeny or my employees wi�h wages as �heir sole compensaiion, will Uo �he work, and the ❑ s�mclureis notimendetl orot�eretl torsale (Section 70d4, Business anU PmiessionalCode: The Contrattors' State License Law tloes noi apply �o an owner of a pwpehy who builtls or impmves [hereon. anA who does suc� work himselflherself or thmugh hfs or �er own employees. proviae0 ihat such improvemenis are not inten0e0 or oflereU lor sale. If, �awever t�e huilUing or improvement is so10 within one year ol completion, ihe owner will �ave t�e burtlen ot pwving he/s�e tlid not build or improve tor Ihe purpose o� sale�. I, as owner o� the property, am exclusivelg coniracling with licensetl coniractars to conslmc� �he pmlect ($ec�ion 7044, Business ❑ antl Prolessions Cotle: The ConVacmrs' State License Law does not apOry to an owner oi pmperty who 6wlds or improves thereon and who comrads for such pmlects with a contramoqs) license Dursuant lo Ihe Contractors' State License Law�. I am aware t�ai pmof oi �heir Worker'S Compensaiion insurance 5h0ultl be pmvided �o me. � I am exempt untler Seclion'. B. 8 P. C. for �his reason'. Dale: Ownec I tlo �ereby ceNfy Iha� I am aware of and untlerstana �he reQuiremenl5 of Cali�omia Healih and Safety Code Sections 25505, 25533, anA 25534 antl I�at I or any iNure building occuDanl willlwill not (circle one) need Io comply wiih said 5late co0e5 antl ��e reQuiremen�s for a permi� �or conslmc�ion or motlilicalion hom ihe Air �uali�y Management DisVicl. Aesiden�ial constmciion aDPlica�ions are exemp� Irom �hese provi5ions. Date: Appiicant: I hereby cetlity I�at I have rea0 ihis aOPlica�ion antl sta�e �ha� I�e above in�ormalion is carrecL I agree lo comply with all ciry anE couniy ordinances anU stale laws relating Io builtling consimdion antl hereb represenla�ives at this ciry to enier upon �he ahove-men�ione0 pmpetly �or inspection purposes ' Oaie: �� Signalure � //! / 16A1�46 W�ite—Butltling; Green—Cotle Eniorcemenq Canary—ApPllcanl; Pink—Revenue; Goltlenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 067969 PERMIT NO: B 067968 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STH PURPOSE: OTH JOB DESCRIPTION : T/OFF 6 REROOF WITH COMP, & BUR IN BACK SC� FT; 1,100 CLAIM VALUE: 1,100.00 CALC—VALUE: 1,100.00 GROUP t]CC: R-1 /M-1 COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM S HALLWAY **�c-x�c-�****�+t�**#*t**�r*aa***;�**+c�**�r�**�r*��n�r+�*�c*�r�t�**�**�r�*��e��*�t��t�#t�#�*��r��*�r�* Z O N I N GS ERTEBQAUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDIP7G --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41808242 ZNE: REF NO: PLANNING NOTES> :i !' 3ritjritie�xir�rft��riri:kiti[�irit�r�ir�r+ricitititicxx�t+t+�ar*itfrit�xitiexirx***u�tr�r*inir*�+r��+e�;;��r+rr':;'�it��tir#aea:�iru� D E V EYL O P M E N T S E R V I C E S R E Q U I R E M E N�;T S ZONING APPROVED BY DATE: ;r BUZLDING APPROVED BY : DATE: �:` p. APPLICATION ISSUED BY: �/�� DATE: /� / A� //�P # 9E �fE iE iF fE * iF # f�- x iE iF iF Yc * iF jf 9F �f if ic 9C �%iF iE iE # 3f iE iF 9E 9E 3F dF iE iE it� i:� 3' if ih 1t iE iF 9E if IE 1f jE if �' iE �)f 7f #�f iE # iE iE �}t �IE iE iE iE # iF �lE �)E iF iE a�c iF iE iE # iE LEGALIZATION:N F E E S U M M A R Y STRUCTUAAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 27,00 .50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAIP DUE TOTALS----> 27,50 0.00 0.00 27.50 27,50 ,00 REVENUE DIVISZON TOTALS--> COLLECTED: 27.50 OVER/SHORT: ,pp BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRIiDING PLAN—CHECK 27.00 ,50 iE iE �F # fElE ik iE iE jE 1E i1� iF iF iE iF iE �E 1f iE 1F 1E i"r iE 1E iE fF iE �F iE 1E iF * iE iE i4 iF iF #' i! �IE iElE iF iE iE iEiE!(� * iE if iE iF �A if 1E iE iE iE f(� 1F :�E iE iE iE iE 1f �; it if iE iE jt iF 3E 1l- if iE I N D I V I D U A L F E E B R E A K D O W N TYPE C,�TY D E S C A I P T I O N UNIT COST TOTAL COST SFR 1100 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 1,100,00 END OF FEES Y O1 401b3764—OO1b375S T 4 T ?7,7t� DATE: 07/1t/94 TI11E: 11:72 CONSTRUCTION ANDPLANNiNG POOL op � Date Inspector Date inspector APPROVALS Permit # APPROVAIS Permit # r .: 1. Tempotary Etectricat Servic��r Pole �. 52. Pool & Equipment Location /�� 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electricz� Conduii�Undrgrnd. 55. Electrical Bondin9 5. Steel Reinforcemen[ 56. Rough Plumbing & Pressure Test ! 6. ElectriCal UFER Gmd. 57. APPROVA� TO COVCR�GUNITE j' 7. Footings 58. Electricai Conduit�Undrgrnd. � 8. Foundation �� ; � 59. Gas Pipe, O Undrgmd., Tesc ' � j 9. Water PiPe-Undrgrnd. � I � + 7 60. Backwash Lines, P�Trap, V Undrgrnd. , 10. Structural Floor Sys[em i.%- :,,' 67. APPROVAL TO DECK -'� 71. PropertY Sewer �ine & House'Gonnection f;, 62. Backwash & Receptor�Final � _�� 12. Sewer Gap 63. Heater & Vent-Final 73. Roof Drains 64. Plumbing Sys.em - Pinal .t 74. Rough Plumbing 65. Electrica6Final �'" I 75. Rough Electrical�Conduit 66. Solar System�final ^� �16. Rough Electric Wiring 6Z Fencing & Access Approval �' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - Y 78. Rough Electrical-T Bar Ceiling 69. POOVSPA SYSTEP,15 FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilacing 71. Product Piping � Gas ❑ Oi1 23. Gas Pipe•Rough & Test 72. Underground Flush � 24. Roof Praming J3. Undergmd. Smrage 7ank i� Gas ❑ Oi! 25. Roof Sheathin9 ?��q.-�!j �� 74. Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemicai � 27. Frame and Flashing ' 76. Dry Standpipe 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIflE PREV. FI�VAL 30. Orywall Nailing HEALTH OEPT. REQUIREM1+iENT 31. Plaster Brown Coat 79. FINAL INSPECTION I 32. Electrica� Powzr Meter�F�nal 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Fin31 H¢Bting & Air Conditipning i 35. Final Gas Pipe-Test ` ' 36. Hood or Canopy , 37. Final FBctory Fireplace 38. Final Piumbing 39. Water Service�Final 40. Gaz Service-Final 41. Solar pomestic-Final 42. Backflow Preventer '_ 43. BacktloW Irrigation � 44. Landscave Irrigation Syscem 45. Sound Attenuation 46. HandicaP Regulations ' 47. �(NAL STRUCTURE & BUILDING ��O-qy 6�=6�° 48. FINALPLANNWG . ". �� - 49. Electric Release to Edison `"` . 50. Gas Release to Southem California Gas Cn ' 51. CERTIFICATE OP OCCUPANCY " No. Date . CITv oF COSTA MESA CONSTRUCTION PERMIT Project Address 4� 3� Lo`(`(;i� Qa: �C_T\- Applicant'sMailingAddress ��C)O °�(1_Of^�9J.CCl Owner's Name '.S • � - ' ��-�� Phone ' � T �� ' Address - Q�3� ` �Mb Arch/Eng. � License No. � , � � Address � � - - Contrector'sName� �.S T: �. r�� no e@Q$-j\� Address (mailingl ��4%�� OC'1�1.c � Ciry.LicenseNo. ' 3��4�. LICENSED CONTRACTOR DECIARATION I�hereby:af(lr�m that I am licensetl u mm provisions ot Charter 9(tommencing wiih section 7000) of Division - oi th Business n rotess Cotle, antl my Iicense is in full force antl eft ct. . � License.Class � C- O L e se No 3��04 Date �OTL7 � Signatur WORKERS' COMPENSATION DECLA ATIO � hereby'atfirm that I nave a aertiticate of consent to selt-insure or a<ertiticate ' Wo�ke�s: Compensdtlon Insurance, o� a certifietl copy thereot (Section .800, Lab. C.) ' - aorcv No.wcP l�014413 comPa�v:�oCi� %fM.A:ChY� e Certifietl copy is hereby furnishetl. ; . ' . Certifi tl c p is filetl with [he city Builtlir�9-C)ivi�. � N�, 9 Date�APPIicSM �/� - EXEMPTION FROM W00.KERS:COMPENSATION DECLARATION (This section neetl not be com0letetl it the permit i5 tor ane huntlretl ($300) or less). I certify that in the pe(fo�mance of th¢ work fOr wM1ich this perm�t is issuetl, I shall not em0�oy any person in any manner so as to become subject to the Workers' Comoensation Laws ot Califomia.. Date ' Signature - � NOTICE: If, after making this tleclaration, you shoultl become subject to the Workers' Compenution. provisions of the Labor Cotle, you must torthwith comply �with such ptovisions ot this pe�mit shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCK �' '' - J I her¢by affi�m that tlte�e is a constiuction IenEing agency�for the pertormance of [he 'wo�k fo� ,which this permit is is5uetl (Section_3097 Civ. CJ Lentler's Name` , Lentler's Atltlress � - . OWNER BUILDEF DECLARATION�� ' `�- ' � I hereby atfirm.that I am exempt from the Contractor�i License Law for tne followinq �eason (Section ]031.5 Bu5ine55 antl Professional Cotle:-Any city o� �OD�icant to fill in al1 spaces except thase within heavy boraer lines ana sign all avvrovriate tleclarations. PER.N}LT NO. �� TftACT NO. ' LOT NO. UNIT NO. � (;�5 ZS " . � . TVPE OFCONSTRUCTION NEW � DO ALTERATION- REPAIR �❑ CONVERSION ❑ DEMOLISH � OTHER A p # .. DESCRIPTION OF WORK/USE OF BLDG. ' - S Main Building: E TVPE�OFPERMIT GRADING FOUNDATION STRUCTURAL T Pront' � ❑ TENANT �LEGTRICAL ❑ PLUMBING ❑ MEGHANICAL B R¢d� . . ❑ -OTHER � _ ' ' . : . A ' . C Right PRQIECT DESCRIPTION SQ. FT. -0CCUPANCV' ' � K. . CON STRUCTION TVPE VALVATION $� S Left . ZONE � � GRADING CU. VDS. �� ACf3E5 , p�ng. Ref. # Remarks: • . � � � ' ' , Planning Notes: ucture, prlor to�its.issuahce,-also requires the�applicant for such permit . a signetl statement'thaT he/she is licensetl,pursuant [o the provisions of , ,�.� r... � i��enco i aw �cnan�nr 9 lcnmmencina witli Section ]OOOf�o( � +re(rom�antl [he basis for, the allege0 exempLon. !any vioiauon oi oecoon � .3115 by any applicant for a permit subjects fhe apP!icant to:a civll Ce,nalty of not more tnan live huntlretl tlollars ($500).' � � LJ I, as owner o( tM1e properryl oY� my=¢mployees with wa9e5 as tM1eir sole wmpensation, will tlo the wo�k, antl the structure is,not Intentled o� otferetl � for sale (SeGtion ]044, Bu5ine55 antl Profe55ional Cotle: The Contractor's LicenSe Lawitloes not apply�to'an ownerpf�a property who builtls o� imp�ove5 � thereon, anE who tloes such work himself/herseli or throu9h his or her own empioyees, provitletl that such improvements are not intentletl or offerea for sale. If, however, the builtling cr imDrovement is soltl within one year of com- pletloq the owner will M1ave [M1e burtlen of proving he/she tlitl not builtl or im- �rova tor the purpose oi sale). I„as owner ot the property, am exclusively mntracting with licensetl con- traCtors to construct the p�oject (Section ]044, Business antl Protessians Code: The Contractor's License Law Goes mt apDly to an.owner of property who builtls o� im0�oves tM1e�eon, antl who:contracfs-for such projects with a con- tractor(5) license pu�suant-to the Contractor's License Law). 1 am aware that proof of their WorkeYs Compensation insurance shoWd be provitletl to me. ❑ I am exempt untler Section � B. & P. C. for this reison t oate � Owner. � � � � � � I hereby certi�y thaY'I have'reatl this application antl'state that the above Information is correct.'I agree to compry with all city antl county ortlinances ' in5pectlori ur os � Siqnature Drivers' License or 55 �� CMF 0865-46, rev. 4/84 tl Sink kflow Preventer kflow Irrigation king Fountains �r Drains ir Sinks Service i Interceptors Kitchen Sink '. Lavatories. ' P-T'rap <' Roof Drains _ � Reinspection:Fee SAowers ' - Service Sink� � � Sewer Cap Sewer Connection Solar Collectors � � Solar Pipin9 ' ' • Solar Tank � Swimming Pool w/Spa, � - �Urinal � - _ - �Outlets ' �WaterCloset �� - � � Water Heacer ' � - Water Service .. � ' _ , ( I . , � $15 . Issue Fee Boilei � Duct�UnderGraund Duct-Strucmral � • ' Duct-Ventilating ' Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting � ❑0-100,000 BTU 0100,OOOBT �� _ �_ � � ( . I � I ReinsPection Fee White - Builtlinq; Canary -Applicanh Pink -Accounting; Goltlenrotl - Assesso� $15 Hood or Type I ❑ , Canopy Typell ❑ Refrigeration System � ❑0-100,000 BTU ❑100,000 BTU System Repair/Alteration . Issue Fee � $ 3 - 9810 10/10/84 . � 8:00 TL Zone � ' ' � ' � 'Accessory Building: ' _ - Z , ,_ . � N . _ � • N , G R � Parking ReqJProvided � � ' E � M 1 , � ' - :" � . . T Automatic Washer� � Constructior Pole Sub. Cooking Unit � ' i � � . i _ � ELECTRICAL . FE - -- Transformer ❑ 15-50KW — ❑ 50+KW ' • Meter ❑up to 700 amps ' Meter ❑over 100 amps� ' Dryers UGas UElectric Fan � F,A,U. Fixtures - - - - - : Device Boxes � � ' OUtIEtS Switches Garbage Disposal . Generator DO-5 KW �5-15 N 0 I Reinspection Fee � DEVELOPMENTSER 2oning Approved By _ Buildin9 Approved By Application Issued BV_ Sub.Panel � Motors �0-1 HP 01 %- 8 Inc.Solar �9-15 HP �16-15+ - Microwave � - � Pole Light � � Range � ■ R Standing Sections ' Trash Compactor \ � C�_ � G luue Fee` ' $ 3 . , SUMMARV OF FEES , � BUILDINGPERMIT $ SMIP $ PLAN CHECK $ ' .PERMIT � PLUMBING , $ ' ��SSUANCE $� PLAN•CHECK 25% $ ,ENERGV P.C. $ � ELECTFICAL $ ' � OO �GRADING $ � PLAN CHECK 50% $ �MICROFILM $. f MECHANICAL, $ � TOTALFEE , $� g.�C, PLAN CHECK � 25% $ ' ' u� CONSTRUCTION ANppLANNING - � ��O ;PA_ APPROVALS Permit#£��S Gx� Date �� Inspector ��AppROVALS Permit# � Date �� Inspector - � 9. Temporary Electrical $ervice 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. Electiical Bonding � � 5. Steel Reinforcement 56. Rough Plum6ing & Pressure Test 6. �Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE � 7. Footings ' - ' . 58: Electrical Conduit-Undrgmd. � � - 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 � ' 75. 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 �nditioning � FIRE DEPT. REQUIREMENT � .. 2Q. Rough Factory Fireplace � APPROVAIS� Permit# 21. Ducts,�in Structure 70. Underground Hydro � . ' 22. Ducts, Ventilating ' '71. Product Piping O Gar ❑ Oil . � 23. Gas Pipe-Rough & Tesc . � 72. Underground Flush � - ' 24. Roof Framing , � 73. Undergrnd.StorageTank OGas ❑Oil _ -25. �Roof Sheathing � � � - , 74, Overhead Hydro '. ' 26. T-Bar Ceiling (Structural) & Monocoat ' � J5. 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 � � � i � � .' ' HEALTH DEPT. REQUIREMENT 31. PlasterBrown Coat 79. FINAL INSPECTION � � 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric , � �� Notes: � � 34. Final Heating & Air Conditioning � ,. i ., . � 35. Final Gas Pipe-Test ` . ; � � • 36. Hood or Canopy � , � � � . � ' � - � . 37. Final Factory Fireplace � � j � � , 38. Final Plumbing ' ' � � 39. Water Service-Final , . � � - � 40. Gas Service-Final � . , ^ � , 41. Solar pomestic-Final � � - � - 42. Backflow Preventer . � ' � � � � � 43. Backflow. irrigation -,,, , �,,-_»; � -;, _ . � . 44. �fandscape Irrigation System - , �. 45. Sound .Attenuation . + �� ' � � � � 46. Handicap Regulations + � � � � � - � 47. FINAL STRUCTURE & BUILDING • � � � . � ' � - 48. Special Requirements Completed � . , 49. Electric Release to,Edison . �, - � , � , � • , 50. Gas Release to Southem Califomia Gas Co ' ,' �' ' , 51. CERTIFICATE'OF OCCUFANCY ' � � ,. No. Date ' TRACT No. 10445 DATE July 14, 1980 LOT N0. 42 ADnREss 913 Lombard Court, Costa Mesa, CA 92626 ( Development Services bepartment Planning Division City of Costa Mesa 77 Fair Drive Costa Mesa� CA 92626 Attention: Mr. Paul Dudley Dear Mr. Dudley: Please be aware that the undersigned are aware that a certificate of occupancy on the above referenced lot and unit is being requested prior to the entire tract and its streets and co::m:on areas being comp].eted and accepted by the City of Costa Mesa. BY / IC�✓+,�vt�� (/� /�7/fi '`/1/� j��-- SIGNATURE OF PURCNASER) BY P ��r -�,�,�' ( G OF DEVELOP R AND OR UTHORIZED REPRESENTATIVE) BY (SIGNATURE OF LENDER) - . R CE�v �� C� �F.�, ` 19a� QM )��-1 � 4� 6 p�M`$`9��0��'�i��`3i � � �; w. :°' TRACT N0. 10445 DATE July 14, 1980 LOT N0. 42 ADDRESS 913 Lombard Court, Costa Mesa, CA 92626 Development Servtces Department Planning Division City of Costa Mesa � 77 Fair Drive Costa Mesa, CA 92626 Attention: Dlr. Paul Dudley Dear Mr. Dudley: Pleasp be aware that the undersigned are aware that a certificate of occnpacecy on the above referenced lot and unit is being requested prior to the entire tract and its streets and common areas being completed and accepted by the City of Costa Mesa. \ _ �� , i� BY �'i. / , t . �;:.. ....: �.,. (SIGNATURE OF PURCHASER) i . BY��"''ii , � +•�� • �2F'.GG% G !?•L.c�:C�- . . (S G . OF DEIIELOP R AND OR ' Y�ITf'Hf1RT7FT1 RFPRFSFNTAT7VF.1 u Applicant to fill in all spaces exceot tnose witnin heavy bortler lines ana sign all appro0riate aeclarations. CITY OF COSTA M SA ONST UCT ON PERMIT Project Address ' _ ApplicanYs Mailiq ddyess �/�/�� Owner's Name Phone �7� Address ArchlEng. License No. Address �` Convacror'sNa9 ��C Q �hor�� vw Addresslmal" I ��/ �-/ � L City License No. J/e'/� � � LICENSED CONTR/ICTOR DECIARATION 1 hereby affirm that I am licensetl untler provisionz ot Chart¢r 9(commencing with section ]000) of �ivision 3 ot the Business antl Professions Cotle, antl my license is in full i�f a eftect. ��,r�� Licen e Class `>� Lic se o.�1L/�� Date Signature WORKERS'GOMPENSATION DECLARATION i hereby affirm tha[ I hav¢ a certifitdte Of mn5ent to 5¢I6insure Or a Certi(icate 'Workers' Comp/e�nsation�7I�njsurance, or a certifietl copy tn/�ereo�fM (S�ection �0. Lab. �^%lJ "Od � I��i Y(iC/l(F licy No. �� COmpany ny��.ertifietl copy is hereby furnishetl. YJ certitietl� c��%pX� s tiletl with the dt i i io �// _ Oate��"�,�vn Applican��/`� �� E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (TM1is section neetl not be completetl if Ihe permit is for one huntlretl (y100) or less). I certify Nat in the performance ot the work for which this perm�t is issuetl I Shall not employ any pe�son in any manner 50 as to become subject to t{�e Workers' Compensation Laws of Calitornia. Date Signature NOTICE: If, after makin9 this tleclaration, you shoultl become subject to tne � Workers' Compensation provisions of the �Labor Cotle, y0u must forthwith comply.with such p�ovisions or thi5 permit shall be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV 1 hereby aHirm lhaf ihere is a construction lending agency for the performance of the work for which [his permit is issuetl (Section 3097 Civ. C.) LPntler's Name lentler'S Atltlre55 OWNER BUILDER DECLARATION - 1 hereby affirm ihat I am exempt (rom the Contractor•s License Law for the tollowing reason (Sectlon 7031.5 Business antl Professional Cotle: Any city or county which requires a pe�mit to con5truct, alte�, improve, tlemolish o� repai� any structure, ptlo� to it5 is5uance, also requires the dpplicant fo� Such pe�mit to (ile a signetl statem¢nt that he/she Is IicenSetl pu/suant to the provisionz of the Contractor's License Law (Chapter 9(commencing with Section 7000) of -Division 3 ot lhe Business antl Protessions Cotle) or that he/sne is exempt •�etrom antl thE ba5is fo� the alle9etl exemption. Any viola[ion of Sectlon 'd.5 by any applicant for a permit subjects the applicant to a civil .alty of not more tnan five huntlrea tlollars ($500). �.1 1, as owner of the property or my employees with wages as their sole, mmpensation, will tlo the work, antl the struc[ure is not intentletl or.o(feretl for sale (Section 7044, Business antl Professional Cotle: The Contractor's License l.aw tloes not apply to an owner of a property who builtls or improves thereon, antl who tloes such wo/k himselt/h¢r5elf o� tM1�ough hi5 O/ he� own employees, provitletl that such improvements are not Intendetl or offeretl tor sale. If, hOweve�, tM1e builtling o� imprOvement is Soltl within one year of com- pletion, the owner will have the burtlen of proving he/she tlitl not buila or im- prove forthe purpoze of sale). � ❑ I, as owne� of the property, am exclusively contracting with Iicen5e0 Con- tractors to construct the Oroject (Section 7044, Business antl Professions Cotle: The Contractor's License Law tloes not appty to an owner o( property who builtls or improves thereon. antl who cont�acts to� Such oroiect5 with a r.on- tracior(sl hcense pursuant ro me Contractor's License law). I am aware tha[ proof of theit Worker'S Compensation insu�ance sM1oultl be pravitletl to me, ❑ I am exemp[ untler Section B. & P. C for this reason Date Owner I hereby certity that I have rea� information is correct. I agree to antl 5[ate laws �elating to builtlin sentatives ot tnis city to enter inzpection pur0 Signature Drivers' License or 55 � tate that tne above tl county ortlinances aby au[horize repre- ionetl Property��topr� Date�v o a N��.%.o.s-[i � _ _- � � __ ._. TVPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WOFK/USE OF BIDG. TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL PlUM81NG ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. ' oCCUPANCv CONSTRUCTION TVPE VALUATION $ ZONE � GRA�INGCU.VDS. ACRES Remarks: Sink <flow Preventer <flow Irrigation Drinking Fountains Floor Drains Floor Sinks GasService Outlets I ntereeptors Kitchen Sink ' Lavatories , P—Trep Roof Drains Reinspection-Fee � $15 Duct - Under Ground � Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt �C80 # Heating System & Ducting ❑0.100,000 BTU 0100,000 Reinspeccion Fee � $15 0865-46, rev. 5/B8 Whi[e - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Isue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeratlon Sys[em ❑0.100,OOOBTU ❑700,000 System Repair/Alteretion Fire Dampers Registers � Issue Fee $ 3 FEES $ 3 A.P. # S • Main Buildi E T Front A � Rear C Right K - Left S . Ping. Ref. # Planning Notes: Auromatic Washer Construction Pole Sub. Cooking Unit , Dishwasher ... Fan F.A.U. Zone Building: /Provided ELECTRICAL Transformer ❑ 15-50KW ❑ 50+KW Device Boxes , OuHets Switches Garbage Disposal Generator 00.5 KW 05-15 KW Meter LJup to 100 amps Meter ❑over100amps Sub Panel � � Motors OO-1 HP 01 %- 8 InaSolar �9-15 HP �16-15+ Microwave Pole Light Range Standing Sections Trash Compactor � Reinspection Fee '$15 � � Issue Fee DEVELOPMENT SER VICES REQUIREMENTS: Zoning Approved By Building Approved By Application luued By FEES $ 3 O N I N G R E � M T S. SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ lPERMIT PLUMBING $ �Ov ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ ��}-Jy MECHANICAL $ TOTAL FEE $ ��y� PLAN CHECK 25% $ � �s Q17QL�JD3'Q��1�G3 T�T i.�: e�rE: oira<�84 t�nE` i.::c2 .. Y . . _ _ « . . . . ,.�„�... ,.... . .. , " 'CONSTRUCTION AND PLANNING POOL�=;,:p:�AA . ACPROVALS 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-Undrgrnd. : � 54. Forms , 4.�Electrical Conduit-Uniirgrnd. . � � 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, � 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 , n 1. Rou h Electrical-T Bar Ceilin � �$ 9 9 69. POOL/SPA SYSTEMS FINAL �19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' j 20. Rough Factory Fireplace APPROVAIS Permit # '21. Duc[s, in Structure 70. Underground Hydro '- 22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & 7est " 72. Underground Flush - 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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 1� 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or CanopV 37. Final Factory Fireplace � 38. Final Plumb(ng '} (t L� ' 39. Water Service-Final .�„'+ . . � � 40. Gas Service-Final " ' 4�. Solar pomestic-Final;,,� � 42. Backflow Preventer ; � � � , �? .i 43. Backflow Irrigation,� � ;, � 44. .Landscape Irrigation System ' �� 45. Sound Attenuation � . (�l\ 46. Handirap Regulations y � 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed . • 49. Electric Release to Edison � �• . •� :1.. 50. Gas Release to Southern California Gas Co . �.;'✓' ��i' 51. CERTIFICATE OF OCCUPANCY � 7� L�� No. Date