HomeMy WebLinkAbout917 LOMBARD CT - Building Permits,
U�ECT AD�flESS ) S% LOMBARD CT
oi�ven�sname: WALTERS, A CARROLL
; •aooness: g 17 LOMBARll CT
COSTa MESa,r_A 92626
ANCHIENGINEEH:
AO�NESS:
flEG.NO.:
UNIT:
UNIT:
PEPMITTEE: DILT—WELL ROOF AND MATERI (719)739-1288
aooness: 3310 UERDUGO ROAD
LOS ANGELE.S CA 90065
LICENSED CONTFACTOB UECIAHpTION: I hereey alfiim thal I am licensetl untler Dmvisions o� Chap�er 9(commencing wi�� Section
70001 0l Division 3 oi �he Business antl Pmfessions Cotle, antl my license is in �ull force antl eifect.
ciTruc.: 0340/n7.6/ STATELIC.:GJHOO'��u���i� 39 EXP: OS/95
�ate: �/��J�K�r(__ Signaiu ' �
WOB¢EHS' COMPENSATION OECNBA710N: I �ereby af ave a cenificate of consent to self-insure or a cenificate oi Workers'
Compensalian Insurance. or a cenifie0 copy �hereoi (Sec�ion 38�0. La�. C).
PoucvNo.: W937102984 exv.oaTE: 07/13/99
COMPRNY: CAL COMP
❑ Certifietl coOY is hereby lumishetl. �. Cenihed copy is liletl with Ihe ciiy Buil4inA Oivision.
date: Applicant
E%EMPTIONfBOMWOBKENS'COMPENSATION�ECIAflATION: Qhissecfionnee0nol0ecompleteOi�tAepermiti5�oronehunOred�5100)orless).
I certify iha� in t�e �etlormance ot �he work �or whic� �his permii is i5sue0. I IMolew oy any erson in any manne� so as �a become
su�jeci �a Ihe W rker.' Campensation Laws ol Califomia.
Oa1e'. Signa�ure: __
NOTICE: Ii. atter making t�is tleclaration. you s�auld hecome ' o t�e Warkers' Compensation Dmvisions oi ihe Labor
Catle. you musl forthwith comply wilh suc� pmvision5 or I�is permi� shall be OeemeE revoketl.
CONSTFUCTION LENUINC AGENCY: I hereby a�firm ��at ��eB is a consimc�ion lending aAency for �he peAormance o� the work for
which Ihis permit is issued (Sedion 3097. Civ. C).
LENDEH:
anoness:
OWNEF BUILUEB OECLAFATION: I herehy attirm Iha� I am exempt trom t�e ConVactor5' Sta�e License Law for t�e lollowinp reasan
(Sectian 1031.5 Business an0 Pmfessional Cotle- Any ci�y o� counry which requires a Oermi� to conslmct, aller, impmve, Oemolish, or
repair any stmcture. pnor ta its issuance. also requires the applicanl for such permit to file a signed statement ihal he/she is licensetl
pursuam io Ihe pmvisions of the Coniracmrs' State License Law �Chapter 9(commencing with Section 7000) oi �ivision 3 oi the Business
antl Pmlessions Cotle) or �ha� he/she is exempt �here�mm and the basis �ar Ihe allegetl exemp�ion. Any violation o� Sec�ion 703L5 by
any applican� lor a Dermii suble��s Ihe applicani lo a civil penalry o� not more than live hundred Aollars ($500�.
I, as owner of ihe pmperty or my employees with waAes as Iheir sole compensation, will �o ihe work, and ihe
❑ simcwre is nol inlendetl or offered for sale (Section 70aa, Business anU Piofessional Cotle: t�e Contracmrs' State License Law
tlaes nat apPty ro an owner ol a pmDehy w�o Ouiltls or impmves thereon. anU who tloes suc� work himselVhersetl ar t�mugh
his or her own employees, pmvitle0 �ha� such improvemenis are n0� inlentle0 or oilered �or sale. I�, however I�e Guilding or
impwvemen� is soltl wiihin ane year ol comple�ion. Ihe owner will have the huraen oi Droving he/she tlitl no� Uuiltl or improve
for Ihe purpo50 of sale)-
I, as owner of �he pmpeny, am exclusivelp coniracting wilh licensed con�rac�ars �o conslmct ihe pmleci �Section 7044, Business
❑ and Pmiessions Coae: The Coniractors' Slate License Law tloes not appty lo an owner ol properry who Ouiltls ar improves [hereon
antl who cmtracts �or suc� pmleds wilh a conlrac�or(5) license pursuant to t�e Conirac�ors' Sta�e License Law). I am aware
�Ilai pfao� 0� IhEiI WOfkEr 5 Cumpen5a�ion in5urapcP ShOuld bP plOviO¢tl lo me.
� I am exempt under Section: 6. 8 P. C.
for this reason'.
Oate: Owner
I tla hereby cenify �hat I am aware of antl under5�an01he requirements o� Califomia Health anA Safeiy Cotle Sec�ions 25505. 25533, anA
25534 an0 ihal I or any fuNre �uilaing occupanl will/will nol (circle one) need to comply with saitl state codes antl ihe requiremenis for a
permil lor cons�mc�ion or motlilicalion imm Ihe Air Ouality Managemen� Ois�ric�. flesi0en�ial cons�mction apDlica�ions are exempt imm
IheSe pfovl5i0n5.
oaie: Applicant:
� hereby cerlity Iha� I have read Ihis applica�ion and s�ale Ihal lhe above in�ormaiion is correcl I a0ree ta comply with all ciry antl counry
ordinances antl Slalelawsrelalingio building cons�mction an� hereby au ute+ep en�alives f�his ci�y�a enier uponthe above-mentioned
pm0etly lor inspection p/u/rpos�
Oale'. K� SignaWre'. �^('
�
16a1-a6 Wlnte—Butltling; Green—CODe Eniorcement; Canary—AOPlican�', Pink—Ravenue; GOltlenro0—Assessor
CITY OF COSTA MESA - HUILDING PERMIT PERM NO: H Q5797�
PERMIT NO: B 06797"L PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE: V-N PERMIT TYPE: STP. PURPt�SE; OTH
JOB DESCRIPTION : T/OFF 6 REROOF WITH COMP, 6&UR IN BACK SQ FT: 1,10�
CLAIM VALUE: 1,100.00 CALC-CrALUE: 1,1QO,p0 GRtJUP OCC: A-1 /M-1
COMMENT3: SMOKE DETECTORS ARE REQOZRED IN EVEt2Y BEDROOM & HALLWAY
� K iF 9E iE ie jf if # iE iklF iE if 9F i@ iE %iE iE �IE if'lE iF �)F �4 iP it iE iE ib df jF iE iE iF # 1E iF # iE # 3! iE iE it iF 9E ##� 1' iE jP iF iF i: iE 3} )F ###F islE ##')f �1: iE #} i: # i: #Y %i:9E
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING --- ----- -------- �{CCESSORY BUILDZNG ---------
FRNT: FT IN AEAR: FT IN FRNT: FT IN REAR: FT. �t`1
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; PZ' IN
PARKZNG REQ; PROV; PARCEL: 41808246 ZNE: REF T10:
PLANNING NOTE3> ��
> 'r.
it*x��x-�r�t*ititiritit�itf:ft�tiFft�rit�i��x��f�*xftie�ei�7rir*iCfEic�rt�t#*��ic�i�-�t�r�xtit�+ti��t�*�e*fri��;-+t*tc�+eiE*�t;F�iri�#r�x�x�*ir�
D E L� E L O P M E N T 5 E R V I C E S R E Q U I R E b1 E N� T S
w:.
ZONING APPROVEb BY DATE:
BUILDING APPROVED HY : PATE: �'
APPLICATION ISSUED BY: ,�/�/
/�/��-- DAT E :
,��**��,����,�*����,�*��,�����.����.�,�,��� �,,:�xx,�<�x�m.,�x��.�x.�.*�**#.���;�;.�.��x,���..-�.ti_
iEiFkiEiEifiEi#it�ltiFiE#iEiFif 1'iEiriEiEiE3EiEiEiEY; iFiEi:�iEiFiEiF?F�tFiFiFiEiFi"rjEiE-r: 3E1Ei; ltiE3E1E?tiEiFjEiFii�}iE#?e�#�Ex, }IFi�ih##iFiF#'M��-�-#�;
LEGALIZATIOPI;N F E E S U M M A A Y STRUCTURtIL SEGMENT:Y
HLDG PMT FLUMBING ELECTRIC MECHANIC
PERMIT 27,00
PLAN
ISSUE FEE
FIRE S'MIP/P.ES GRe'�.DING
,SO
SMIP/NON-RES
bUILDING-DIV-> FERMIT ISSUE PLAN-CHECK TOTAL PAIL� DUE
TOTALS----> 27,50 O.QO 0,00 27.50 27,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 27.50 OVEP.!SHOAT: .00
BLDG PMT PLUMBING ELECTRIC MECEiANIC FIRE SMIP/TOT GRADING FLAN-CHECK
27.00 .50
iF iP ie� if iE it iE x• iE if iE iF i(� iE iF ## i(� iE �k it iP iE # if ic 3E iE i(� 1E iF iE it i49E iF iE if iE iF ik iE±E iF 9f ?;- if 1E X� iP it i: # Y� iF %it iE iE �R-1(� h- 3' iF iE iF i(� if if ya 1F 3f iE 9:-'k #� iF Y�
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL CUST
SFR 1100 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 1,100.00
END OF FEES
DAiEaii7/li/94ih3729 T C�T
f+_. I.1:02
}
CONSTRUGTION AND PLANNiNG POOL !A
FAPPROVALS Permit# Oate Inspector APPftOVAIS Permit3k Pate Inspector
�
1. Temporary Electrical Servic�Pole ',- 52. Pool & Equipment Location
� .,
2. Soil Pipe�Undrgmd. lF 53. Steel Rzinforcement �
3. Electrical Gondu(t Utility-Un�drgrnd. � 54. Forms
4. Electricai Conduit-Undrg:nd. 55. Electrical Bonding
5. Steei Reinforcement 56. Rough Plumbing & Pressure Test '
6. Electrfcal UFER Gmd. 57. APPAOVAL TO COVER�GUNITE ;
7. Footings � 58. Electrical Conduit�Undrgrnd. �
8. Foundation ; 59. Gas Pipe, G� Undrgmd., Test �
�
9. Water Pi e�Undr rnd. ,'' r
p g ��,� j 60. Sackwash Lines, P�Trap, [� Undryrnd. r �
10. Structural Floor System � j � �/ 67. APPROVAL TO DECK
17. Property Sewer �ine & Hoe�se�;onnec.ion i•' / 62. Backwash & Receptor�Final ye'' '
12. Sewer Cap �. 63. Heater & Veni-Final .
73. Roof Drains � ' 64. Piumbing System - final ,��
74. flough Piumbing 65. Electtical-Final
15. Rough Elettriral�Co�du�t 66. Solar System-Final
16. Rough EleGtric Wiring 67. Fencing & Access Approval
17. Rough Wiring Siy� 68. APPROVEO FOR PLAST"eRING
78. Rough EleGtricai-T Bar Ceiling 69. POOUSPA SYSTEPnS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rou9h Factory Fireplace APPROVALS _ Permit �
21. Ducts,in Strutture � 76. Undegraund NVCro
22. Ducts, Ventilating 77. Product Piping C;Gas ❑Oii
23. Gas Pipe�Rough & Test 72. Underground rfush
24. Roof Framing 73. Underyrnd.StorayeTank OGas GOiI
25. Roo` Sheathing '"�i�� qG/ 6W� 74. Overhead Hydro �
[ i
26. 7�Bar Celin9 (Structura�) & Monocoat 75. Dry Chemicai �
27. Frameand Flashing 76. Dry Standpipe
28. �aihing & Siding � 77. FIXED SYSTEA� FINAL
29. Insuiation 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUtREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Mete:-Final 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric Notes:
34. Final Heating & Air Conditioning
35. Final Gas P�Pe-Test --
36. Hood or CanopY ' �
37. Pinal Factory Fireplace
38. Final Plumbing
39. Water Service-Pinal
40. Gas Service-Final �
41. Soiar pomestic-Final
42. Backfiow Preventer
I
43. Backflow irrigation
44. Landscape irriyation SYstem
A5. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILD�NG � ify ��
a8. FINAL PLANNING � �
49. Electric flelease to Edison ��-
50. Gas Release to Southem California Gas Co ...
51,. CERTIFICATE OF OCCUPANCY ,
No. Date
; .
TRACT N0, 10445
LOT N0, 46
nATE September 24, 1980
ADDRESS 917 Lombard Court, Costa Mesa, CA 92626
Development Services Department
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 coa�on areas being completed and accepted by the
City of Costa Mesa.
�iEC1�I VED
SEP 251980