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Home My WebLink About919 LOMBARD CT - Building PermitsPHOJECTROUflES3: 91t� LOM6ARD CT owxeesxung: SHERMAN� +MA�2Y JA�E : RODflE33: [�19 LON�BARU CT , COSTA.MESAsCA 92626 �RCN/ENCINEEfl: �45—J594 pODHE33: n UNIT: HEG.NO.: UNR: ' ' ' GITY OF COSTA MESA.— SUILDiNG,PERMI7 PERMIT fvG: P 052314 PLAN CHEGK ND: R LOkSTRUC7I0N TYPE:`V—N PERMIT 7YPE. PLU J08 DESCfiIPTION : GFiANGE GUT DISHkASHER PEPMITTEE: OOOOO � FDONESS: ��CK PLUPSBING � (7 14 1 89 5-1246 11610 SEABUARD CIR � STANT�N CA 90680 UCENSED CONTMCTOH DECUM710N: I hereby al/irm ihat 1 am IicenseC under Drovisions of Clupter 9(wm enclnA �� ion 7000) ot Division 3 oi Ne Business anJ Pmtessions CaOe, antl my license is in full torce antl effect. cin uc:: 50386 srnTe uc.: 511471 /1 �u� 36 � ate` — [�'_� / SiAnature: � �M(�` _� , WUBNERS' COMPENSRTION OECUMTION: I here0y affirm I�at 1 have a certifcate ai conseN ro selFinsua or a certilicate oI Workers' ' ComDansation Insu2nce, ar a'certitied copy t�ereof (Section 3800, Lab. C). � roucrxo.: 116799290 ucv.o�re: fl3/O1/92 cornrnxr: STATE ,/ �C'nitieE copy is hereby fumishe0. � Certifie0 coDY is fl�[ ,ihe ciry Buip�y A Dinsion. // ' , �a� te:1 � " �B � L' ADPliwnt: -'L�WW�V'�/. %.... e� %�q��.:� E%EMPfION FNOM WOHKEPS' COMPENEI�tIOX UECWUTION: (This ucGon neetl not Ae completetl ii Ne permit is for ane hunOreO ($10� ar Iess�. '. I ceniry that in [he performance ot [ne work for wnich Inis Dermit is issuea, I shall not employ any person in any manner w as lo become ,� suhlect ro the Workers' ComDensation Laws oi Califomia. Date: SignaWre: - ' NOTICE: Ii, atter makinA �his tleclaration, you shoultl Uecome su�lec[ to the Workers' Compensatian Dravisions of iha Labor COAe, you must lorthwilh comO�Y ��h such proNsions or Ihis Dermit shall be tleemeU revoke0. � CON8TBOCTION LFNOIN6 RCENCY: I herehy afiirm that t�ere is a constmction lenainp aAency tor ihe pedormance ot Ihe woB for whicA this permit a iwuetl (Section 3097, Civ. C�. LENDEfl: , I ROOflE33: - � � OWNER BUIIDER OFCIAMTION: I hereby a8irm t�a� I am exempt irom t�e Contractors' State License Law for the following aazon �(Section 7Q3L5 Business anA Protessional Cotle: Pny ciry at counry which requims a Dermit ro cons[mct, alter, imprave, Aemolish, or repair any slrucWre, pnor to its issuance, also requires Ihe applican� for such permit to file a sipned siatemem that he/she is Iicense0 pursuant ta Me D�ovisions oi tAe Coniractors' State Licanse Law (Chapter 9(commencinA ��h Section 7000) of Division 3 oi ihe Business antl Pmtessions Cotle) or IAat he/she is exempt Iherefmm antl the basis for ��e alleped exemption. Any violation of Section 7031.5 6y any aDP��cant tor a DermR suDlects t�e apDlicant to a ciNl penatry ot nat mare tAan Me hun4re0 tlollars (5500). I, as owner of ihe DmDertY a� mV employees with waAes az tAeir sale compenution, will Oo the work, and the 0 strucfure is not intendetl or oilere0 tor sale (Sectian 704d,�Business antl Professional Cotle: The Contractors' SWte License Law � tloes not aOPly to an owner ot a propeM w�� huilds or improves t�ereon, anA who tloes such work himselll�ersell or [hrough �is or her own employees, D�oaaetl ihat such imDravements are not intenaetl or olleretl for sale. If, however t�e Ouiltlinp or improvement is sold vrithin one year ai comDle[ion, ihe owner vnll have Ihe burAen of DrodnB he/s�e tlitl nol bui10 or impmva for IAe purpose of sale). - , I, az owner of the O�operry, am exclusively wniractinp vntA IicenseG contracrors to construct the Omle�� (,Sectian 7044, Business ❑ and Protessions CoOe: The Contractors' SWte License Law does not appty to an owner ol prope�y wha Ewlas or improves �hereon an0 who coniracis tar suc� Dmjecis c�t� a coniractoqs) license Oursuant ta Ihe Contractors' Sta[e License Law). I am aware ihat Draal af ihei� Worker'S Compens:Non msurance sAauld 6e DroviOetl ro me. � I am exemD� un0er Section: � B. 8 P. C. for t�is reason: � Oate: Ownec I tla hereby teeity Ihat I am awaf¢ af and und¢rs�anE the repuirements af Cali�omia Healih antl Safery Code Seclion5 25505, 25533, anA 25534 antl Ihat I or any IUWre huilAinA accupant wilUwill no� (circle one) neetl ro compty with saia state co0es an0 Ihe requiremenis lor a permit for constmctian or mo0ification Irom the Nr Oualiry ManaAement Distnct. Fesidential constmction applications are exemD� ��om [hese Omvisions. Date: I herE Applicant: that I Aave reaU t�is aD7lication antl stab s�ah laws alalin0 �a Ouiltling wnstmtlion pection Durpases. � / ��_ SiAnalure: the above iniormation is wrract. I aA�ee to comDly yit� all city and ereEy a nze reDrese aWes oi t�is ciry ro enter uy� Ne ahovame %� , � �' _ �7 _ l/ oriver's �icense or,sacia� secudry x: 160146 W�i�e—BuilEing; Grean—Cotle Enlorceman�; Canery—Applicam; Pink—Revenue; Galtlenrotl—Aesessor PERM N0= P� 052314 � GOVT:'N SUPP- � - ' PURPOSE: �7H � � SG FT' , � � � GLAIM VALUE: CALC—VALUE:' -, GROUP GGGt_R=3 1- COHMEN'�St SMGKE DETECTaR REBUIREC IN THE HQME ' �a##�*:x��#tx��$m��x�# ��t��x#as�a��z�t� sa�# ara#��a#a###a�ar�#v*atas�aa�t#�##�s##ta�t Z 0 N I fd GS ERTEBflAUCIKRSE M E N T S : ' � .' — MAIN BUILDING ------ � ------ ACLESSORY BUILDING. =-=.�•-- FRNT: �F7 IN REAR: F7 IN FRNT: FT IN REAR: ��FT ;IN IE�T: FT IN RGH7: F7 IN LEFi: FT IN RGH7: FT IN PARKIN6 REa: PROV: PAkGEL: U4180824 ZNE: REF N0: ' PLANNING NOTES> � �zat#�z�s�##a��## amr��#�#a###�#�zaa�m�a#a� ax�aa�a�##:wat#a�x�as#s�s��a##��zs�ax�s#:e#�x#�a*s# D E V E L O,P M E N 7 5 E R V I G E S`5 R E Q U I R E N E N T S� , ZGVING AP�ROVED BY `, DATE= BUILUING APPROVEC HY : �' DATE: APPLICA7iUN ISSUEQ BY:_ �• � DATE_ �� a#�z��##a##t��#s�a*#��3�k�"#��'33�€�'� � � a �z " �a�tm�#�a��# �C###%R�###�C###k�#rt.##i`##it#�1$�#��P%p#�RA#333�kt#�#�k �k#L##�C�P#####$�k###�##�K###4�#��#�#t LE6ALIZA7IUN;N F E E S U M M A R Y STRUGTURAL SEGMENT:.N BLDG PMT PLUMBING ELELTRIC MECHANIC FIRE 5NIP/RES GR1lDIT1G PERMI± 2.00 � 25� SP4IP/NCI�—RE5 ' PL AN ISSUE FEE 3.Q0 � BUILOING—DIV—> PEi2MIT, I.SSUE PLAN—GHEGK T�TAL PAID � DUE TUTALS --> 2.OU 3.00 0.00 5.00• 5.U0 .00 i2EYEM1UE GIVISI(�N i�TALS—> C�LLEGTED: 5.00 GVER/SHGR7: �00 BIDG PMT PLUMBING ELEGTkIG MEGFiANIC FIRE SMIPITOT` GRAGING,PCAN-GHEGK S.Q�, � $R#9�$#ik�k##3f##ik#yf##if#X�t##�k## ###?#��t ########�R#$*h#####�R�C#####�k�#######Y<###Y��R¢t�t I N Q I V I L' U A L F E E B R E A K 0 0 19 t� TYPE QTY 0 E S G R I P T.I,O N U�IT C�ST TOTAL tQST PLU T DISHl�iASHtR 2.00 2.00 � • ENll OF.FEES � 0 A t'. �:C3='''''v ti'��.c5?C 'il';=' � ' - �Hic: �lc��i=.,»i T�("(_: !�.�iY I 0 0 V ,�. CONSTRUCTION AND PLANNING ` POC SPA. APPROVALS Permit # - - Date Inspeetor AppROVALS Permii # Date Inspector ; 1."Temporary Electrical Servicp or Pole, � � 52. Pool & Equipment Location : _� 2� Soil Pipe-Undrgr+ld,.� '� � �,: � , 53. Steel Reinforcement � ;� .3'.- Electricai Cond"uit'�UtSlity-Undrgrnd:+ ^ - 54. Porms - -'4. Ele'ctrical Cond�iYUndrgrnd. � 55. Electrical Bonding �� i5: Steel Reinforceme�t .c 56. �Rough Plumbing & Pressure Test • =6.-ElectricalUFER...,Gind. 57. APPROVALTOCOVER�GUNITE � �7` Footings i� ,� - 58. Electrical Conduit-Undrgrnd. i -8i Foundation � 59. Gas Pipe, O Undrgrnd., Tes[ � r�: 19, Water Pipe-Undr9rnd. � � . 60. Backwash �ines, P-Trap, � Undrgrnd. .� _ 70. Structural floot System- � C� - 61. APPROVAL-TO DECK 11. Property Sewer Line & HoYse'Connection: -; � 62. Backwash & Receptor-Final . 12. Sewer Cap �. 3 , • 63..Heater & Vent-Final 13. Roof Drains '�,., �� '� -_ � _ 64. Plumbing System - Final . _ 14. Rough Plumbirt9� � " J� 65. Electrical�Final '� 15. Rough ElectriW �Conduii - ' � 66. Solar SYstem�Final 76. Rough Electric Wiring . . , 67. Fencing & Accezs 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 _ . .> > : .r' Yr ,� .� :r-: .f. -� .r ., -. _�r -'I -1 s I.. - : 1 aY �: T 9 ir .'� - �t `� 7 f7, nl' "� 20. Rough Factory Fireplace �-� -+ SL N �.y t, ;APPROYALS,y.�-Permrt # - . ' s 21. �Duct�, in:Structure�? ` •' •' - _ � � 'x x �j0. Un_'derground;Hydro � . 22._Dutt�, Ventilating.,n � �' :j 1 .=�,s.-. � - ' � ry- � �� y ) ir rt �71. ProducrP.iping � Gas ❑ Oil 23. •Fias.Pipe-Rough & T.est I �i . +y i _ - ? �� ^h2, Under9round Flush •' _ r 24.-Roof'Friminy` '" � �� _ ;; � � � ._,� '��, ,J3.�llndergmd� Storage Tank O Gas ❑ Oil 25. Roof•Sheathing ��. `� /�` 7 ` �'�" 74r Overhead Hydro .: - ` + -t �� -:�r - +� � .K � 26. T�Ba� Ceiling (5trucfuraq & Mo7�ocoat =; y � �;�.� 75.�Dry Chemical __�,j � � ',:,7 27."Frame and Flashing.�, - -. > >�� ^ 76. Dry Standpipe "' u s� � � r �:as �r� . ., -�28. Lathing & Siding j F'� �'� � � � "� �� "��; � 77,=,FIXED SYS"�EM;FI,NAL�,�,, � , : � �29. Insulation P •� � '�' � � �i { 78�FIRE PREV. FIN�,L' r�-' y'.' '30. DrywalllVailing �'� � � �'�� ' ��' "� .r•- I I I I?brt i^�: ��EALTHDEPT:cREQUIREMENT 31. Plaster Brown:CAao+.�t .; I h-'r •ir I � iri'rrt7g. FINAL IN9PECTION �' y Grd I I 1#�'� �� 32.;;ElectricrrPowe� Meyer�F"� al � t � � �n a�80..'�'OOD CERTIFICA7E ISSUED^, �}' � 1 I v 'Y •� I : .t�r � - -.33.�Final�Electric�> .-,�a �7 I a I i �r<r Notes: -i "�r s�'� "7 .- ' i ' � x r. a - �34. Final'Heating'& Air�Conditiohing � '? '+ � � '•�'f n " i-r o - ;� ,s T c � -'•r � � � � . � } 1 I - ' I+t �c t; � I �- a -:t �-. � rr n a x � .. .' . , - . . ._ . : �35. �FinafGas�Pipe-Testy �� .. �..� I 1 ,al<> a � � � �= :w � rr '36. Hood Or CanoPV = s 7 1'r � J �.i.� I!:1?r ri : ': "�.� tt ~ .T' '!.+ ') I :'n +. I l ; �+f•F a r :;.7 # �'1 "! ' ''I X4 � \� "� F.�� t ,x .� - - �7.,Eina�,Factory Fireqlace,c I- ,r> {: I 1 I.an .T. �n rv -�38. Final�Plumbing ry ��'`� i ✓ �iy�0 � I �� I�t e � < -' � �� 39. Wate� Service-Final# _ � �` 'r � •r•' � � "."' x•_ I I f-"�w�- L' �a �. =40. Gas Service-Final rt r ar-�r � +, n i i I� c '� �' .�:v a� x n:_:- '� o I I i a e .- • - !' n �41. Solar pomesticFinar `` � �� Y ` � 'r'� . "" �� " r� ar i i <ra �o ar:[ � � 42. Backflow Preventera � .�� r i I I+t w � a-� -+ +• ^i �. ir --� �k ir �� .��'3 a r ib -T,CC a Na w- .<, � ~ �� 43. Backflow Irrigationz y ,. � .�.,1.,� i y -� . ,� , ,� ,_ . .. . ., •44. Landscapelrripatior'rSystemJ��n� T x � �a .� .��+''� •� N Y�� #~ v ... .,. �. r .r. n .i .r �: a n � .r r n..c +t c `45.;Sound Attenuationp "'x"' .r �t �- ±- r-�an �+ -+ o-�.: ..a .•- a �1 .. .. � �^4 .�n •Tta t� F- m cr . a• rf 4 + � � x �46..Handicap.Regulations -� : �� _ +��x � = � � S C +F .d � ly u a rn n � a r 7.`�fIN�.�4L STR�ICTUF�,E & BUILDING • ''. � I"''�rt a� v c a sr,- t 4 I o' ,t , 48._�EINAL PLANNINGx ��-!� +` v 1^ it ti � m C +• -- �c I"`Il� .s n !9 N C R S -�49.�Eleciric Release to Bdison � �` � �-i'r '� � `� � " ' .`J n I ii I IM- R�'f! C •r:� SY �50..GasrRelease to 5outhern Califorflia�Gas Co � t I W b�- .+ -�. .�m u t'+ . x i a-i q. ## �• �' �t1J C1 h •V J -51. CERTIFICATE OF'OCCUPPiNCY u r ++ C ^ ^ ^ - �� No. Date ��tdEL� CiiY Of COSTA fJ�ESA p�VF.LOPMENT SERVICES UEPflRTMENT u�r, ':' i980 �M PM ig�9�,., , �,ti�a�5�6 TRACT N0. 10445 DATE � �� y� 2�' 1980 LOT N0, 48 annuFSG 919 Lombard Court, Costa Mesa, California 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 snd unit is being requested prior to the enCire tract and its streets and co¢mion areas being completed and accepted by the � • y��'. i ::�: ; ; �. ' CITY OF COSTA MESA BUILDIN6 DIYISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT (714) 754-5273 • Fax (714) 754-4856 Job Address: 919 LOMBARD CT Suite No Vicinity: Parcel Nunmber: 41808248 Applicant: NOCK,RON Address: 11612 KNOTT ST GARDEN GROVE�, CA Owner: SHERMAN, MARY JANE Address 919LOMBARD CT � � COSTA MESA; CA Contractor NOCK PLUMBWG Address: 11612 KNO7T ST .GARDEN GROVE, CA , Arch / Eng : ,� Address: WATER HEATER. ISSUE FEE Backflow irrigation BackFlow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwaler Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe AMT $23.50 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 , PLUMBING PERMIT Phone: (714)895-1246 Zip: 92841 0 Phone: Zip: 92626 Phone: (714)895-1246 � Zip: 92841 License: 707775 Phone: -� � • Zip: License: � •_ • SCOPE OF PERMIT " � FEESUMMARY QTY AMT � Laundry Tub / Washer $0.00 0 Landscape Irrigation $0.00 0 P-Trap $0.00 0 Pressure Regulalor $0.00 0 Process Piping (per 10 N) $0.00 0 Receptors $0.00 0 SepticTank � $0.00� 0 Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar $0.00 0 Sink, commercial $0.00 0 Sink, Floor $0.00 0 Sink, kitchen $0.00 0 Sink, service/mop $0.00 0 Spa (private) $0.00� QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PEflM �NUMBER 00-00207 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applietl: OS/Oi/2000 Issued: OS/01/2000 ISSUED BY: `/ I� � , Sump Pump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping Qnst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION :.x AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Qn 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 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 wo1k is no4commenced within 180 days, or if work is suspended or abandoned (or a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inapectiona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: � I hereby aflirm under penalty of perjury one of tha following declarations: . � ❑ I have and will maintain a certificate ot consent to self-Insure tor workers' compensation, es provitletl for by section 3700 of the Labor Cotle, tor the pertormance of Ihe work for which this permit is issuetl. ��I have antl will maintain workers' compensaGon insurance, as required by sedion 3700 ot the Labor Code, for the pertortnance ot iha work tor which Ihis pertnit is issuetl. My workere' compensation Insurance carner antl policy number are: . Carrier. �OLDE/�) �F6 G� Poiicy Number. A, 11��f 7��.Y.YU� (Thls section need not be crom0/efed il tbe permit Is velued a( one hundre0 tlallars ($100J or less.) ' ❑ I certiy that in the peAormance oi the work tor which t�is permit is issuetl, I shall not employ any person in any manner so es t hecome subject to the workers' compensation laws of Ca' mia, and agree ihat if I should become subjea to ihe workers' compensation provisions of Section f the 6or Cotle, I shell forihwith comply with ihese provis on App ifal nt Signature: � T--�--� -W Data: � � � �.. �. WARNING FAILUFE TO SECURE WORKERS' fAMPENSATiIXJ CAVERAGE IS U YER�TO CRIMINAL PENALTIES ANO GVIL FWES UP TO ONE HIINOFED THWSANO DOLLARE (St00.000�.IN ADDRIIXJ TO iHE COST OF COMPENSATIIXJ, DPMAGES AS PROVIOED FOR IN SEGTION 3�06 OF THE LABOR COOE, INiERE$T, AND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLARA710N: I hereby attirm that I am licensed unQe[�r�si� forcet2n .d�eitZl. Lic k / with Section 7000) of Division 3 of ihe Business and Professioy3 Code, antl my license is in tull CONSTRUCTION LENDING AGENCV: ❑ I herehy attirm ihat there is a construction lentling agency tor ihe pedormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Code). Lentlers Name: Lendels Address: SigneWre: OWNER•BUILDER DECLARATIONS: Data: I hereby aNirtn ihat untler penalry oi perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Professions Code: Any city or county which requires a permit to consimct, alter, improve, demolish, or repair any stmctura, prior to its issuance, also requires the applicaM tor such permit to tile a signed statemem Ihat he or she is licensed pursuam to the provisions of iha Comractore License Law (Chapter 9(commencing wi[h Section 7000) of Division 3 ot Ihe Business and Protessions Code) or Ihat he or she is exempt Iherefrom and the basis for the alleged e:emption. Any violation oi Section 7031.5 by eny epplicant for a permit sub�ecis the epplicant Io e civil penalty of not more Ihan five hundred dollars ($500).): ❑ I, as Owner of lhe property. or my employees with wage5 as their sole compensation, WILL DO THE WORK, antl Ihe s[ructure i5 not intended or oHeretl for sale (Sec. 7044, Business and Protessions Code: The Comrectors License Lew does not apply to an owner of property who builds or improves ihereon, and who does such work himself or herseli or Ihrough his or her own employees, provided Ihat such improvemenis are not intentlea or oHeretl for sale. IF, however, the builtling or improvement is sold within one year oF completion, the owner-builtler will have the burden of Droving Ihat he or she did not build or improve for purpose of sele.). ❑ 1, as owner oi the property, am E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to conSWct the project (Sac. 7044, Business entl Protessions Cotla: The coniractors License Lew does not apply to an ownar of properry who builds or improves thereon, and who crontracis tor such project with a contractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am exempt untler sec. Business antl Professions Cotle tor ihis reason: Signature: Date: Owner ID venfietl by tlrivefs license. ❑ Ves ❑ No Dnvefs License No. Expires: Venfication of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I �ereby certHy that no escavation tive (5) or more feet in depth into which a person is required to tlescend, will be made in connec�ion with work authorizatl by ihis permit, and ihat no building stmcWre, scattolding, telsework, or demolition or dismantling ihereoi, will be more than thiny-six (36) feet �igh. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tule e, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a pertnit from the Division of Indusinal Safery, as noted ebove, unless such person has a pertnit to tlo such work from the division. Signawre: Date: Division of Intlustnal Safary Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I cetlify under penaity of parjury ihat I have read this epplication and state that the iniormation given is correcL I agree to comply wiih ell state laws antl ciry ordinances relating to builtling wnstruction, antl authorize representatives of the Ciry ot Costa Mesa m enter upon Ihe above-described properry tor inspection purposes. I egree not to occupy or allow occupancy of any building authorizatl �y ihis permit umil tinel inspection. CODE I. INSPECTION7YPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Finel8locWRetalning Wall 202 Finel Factory Fire Place 203 Finel Sign 204 Final Demolition rl5i•=ii Q� INiR1AL5 CO�OF_( INSPECTIONTYPE 206 Final Mechanical 208 Finel Plum6ing 210 Final Electncal 212 Final Fire Prevantion 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupancy �� Vuul16 � PflOJECT AOOHESS: y 1 9 LpMB ARD C T OWNEX'SNpME: S�IF.RMAi� i`�iAkY JANr , aoosess: 9 7. y i.OM�AiZD C i COS'iA M.GSA,CA AHCHIEN6INEEH: !�� 5 — � � y 4 , ADUPESS: 1 e c�o26 uxiT: � flEG.NO.: ' UNIT: � PEflMITTEE: NCJCK tr �]i`i�.Ii�C+ ( 7i 4) 895-�.245 noneess: � 5 K� 0 SEABCiARD C:�H S'fANTON rA' 90680 LILENSEO CONTFACTOP OECIAflATION: I hereby aitirm thal I am licensea untler pmvisions of Chapier 9(commencing wiN Sec�ion 7000� of �iv�sion 3 0l IhE Business antl Pm�essions Cotle, antl my license is in �ull lofce antl ellect. ciTvuc.:0503A6 sTareuc.:��.i.97i ///� c��as�s: C-9 COate-� � ��'— � SignaWrel `-C\d.1.4�__ � WOPNEBS' COMPENSATION DECLAflATION: rereDy ailirm �hat I have a cetlificate ol consent m seli-insure or a certifica�e o� Workers' Compensalion Insurance, or a cetlilietl copy Ihereol (Seclion 3800. Lad C�. POLICY NO.: � j 6�% ��j l y O E%P. DATE: O 3/ O S I�J 2 � COMPpNY: S S A A E �� Cetlilie� copy is hereby lurnishetl. � Certilietl copY is ^fileA vnih the city Bu`ilding OiviSian. �Oate'.-.. ��` � ��` ppplicanC T"✓",� 1 r EREMPTIONFBOMWOPKEH$'COMPENSATIONOECIABATION: (ihiss¢clianneetlnotbewmpletedi�0epermi�isl0ranehun4red�4100)arless�. I cer�ily Ihal in �he petlormance of Ihe work �ar which �his permit is issued, I shall no� employ any person in any manner so as Io �ecome subject �a Ihe Workers' Compensation Laws ot Calibmia. Oaie: - � Sigwiure: NOTICE: Ii. aiter making Ihis tleclaration, you shoultl become su�lec� to t�e Workers' Compensation provisions oi �he Labor Coee, you mu9 lotlhwilh compry with such pmvisions or this permi� shall be deeme0 revoked. CONSTPUCTION LENOING AGENCY: I hereby ailirm 1ha� Ihere is a cons�mction lending agency �or �he pedarmance at ��e work for wnich this permi� is issued (Seaion 3097, Civ. CI. , LENUEX: • � aooxess: � OWNEB BUILOEH DECLAHATION: I �ereby affirm Iha� I am exempt �mm the Con�ractorS' Sta�e License Law lor ��e tollowinB �eason (Sec�ion 7031.5 Business antl Professional Cotle: Any cily of counry wAich requires a permi� to cons�mct, alter, impmve, tlemolish, or repair any slmclure. prior Io its issuance. also reQuires ihe applicant �ar such permit �o �ile a signed s�alemen� �ha� �elshe i5licen5e0 pursuanuo the pmvisions o� I�e ConVacmrs' Staie License Law (ChaO�er 9(commencing wi�h Sec�ion 71100) o� Division 3 0� ihe Business anU Prolessions Coee� or �ha� he/she is exemp� therefmm and the basis �or the allegetl exempiion. Any viola�ion of Sec�ion 7031.5 by any applicanl lor a permi� su�iecls �ne applicant Io a civil penalry of not more ihan five hunOreA Oollars (3500�. I, as owner of ihe propeny or my employees with wages as Iheir sole GomOensalion, will do ihe work, and the ❑ SlmcWre is no� inlendeU or oileretl for sale (Section 7044, Business and Professional Cotle: T�e Contractors' State License Law tloes nol apply �o an owner ol a pmperty who builOs or impmves thereon, antl who Ooes suc� work himSelVhersell or through �is or �er own emplayees, pmvitletl Nai such impmvements are not intentled or ofiered for sale. I�, however ihe �uilding or im0�ovement is soltl wiihin one year oi comple�ion, Ihe owner will have �he burAen o� pmving he/s�e tlitl not builtl or impmve for I�e purpose o� sale). , I, as owner o� Ihe pmperty, am exclusively contrac�ing vnih licensetl conVactors m conslmci Ihe pmleci (Section 70aa, Business ❑ and Pm�essions CoOe: The Contracmrs' Siate License Law does no� apply m an owner o� pmpeny who 6uilds or impmves �hereon antl v�ho conVac�s lor such pmjecls with a contracior�s�license pur5uan�io Ihe Contractors' Stale License Law�.l am aware . thal pmot ol �heir WorkeYs Compen5aiion msurance shaultl be pmvidetl lo me. � . . i� I am exempt unaer Section: B. 8 P. C. lor Ihis reason: � , ' �ale: - Ownec I tlo here�y cenily I�at I am aware af antl untlers�ane ��e requirements of Califomia Healih antl Sa�e�y Cotle Sections 25505, 25533, and 25534 and Ihal I or any lulure 6wlding occupan� will/will no� (circle one� neetl Io compty with said stale co0e5 antl lhe requi�emenls for a permi� lor conslmction or modificaiion irom Ihe Air �ualiry Managemenl DisVict. Residen�ial constmctinn applications are exempt hom thCSE pfOviSi0115. � Date: ApplicanL I hereby CerUty t�al I have reatl Ihis apP�icaiion and Slaie Ihai Ihe abov¢ in�ormation is cOrrecL I agre¢ ro COmply wi�h all Ciiy an0 touniy orainance5antl5ta�elawsrelaling�oOuilaingcons�mctionantlherebyauthorizerepresenialivesol��iscirytaent upon��ea�ove-menlione0 pmpeny lar inspecliofn�purposes. ; � �/� � . oa� Tp' �� SignaWre� �C Ait�� (� �/� i - Driver's License ar Sacial Secunly x: ❑ t64 La6 � Whne—Bmltling: Green—Gotle EnbrcemenL CanarV—APP��canC Pink—Revenue: GoltlenroC—Assessor CITY OF.COSTA M�SA - 3UiLDxNG P�RMI; Pn�,� NO: P 07171_� ? P'crZMIT NO: P 051715 PLAN CHECK iVO; N ,GOVT; N S7PP;.N CONS.3RiJCT,TON TYPE; V-N PERt✓I'C TYPE: PyJ PURPGSn: ��H JOb DESCR'dPT10N ; CHANGB Oi7T Ur DISHWASHcR ' � S�;> r'P: � ,C�A7.M VALUE; CALC-VALUE: , GRpi7P OCC: ft-3 ! CUMAIF'NZ',; 5MORE T'icTECTC>R FtEQ�iJ.IR�.D �kfi#-�Y�/#IEA��Kih�N-if�4��i(�%ihi£�1�iE'rE•1f�XYfif��1E�1F' dc�k�k�7F�X�Mr#MiEiE�A%�%if�k�lE#if�7f�Y.��?:Yifii�If#,.1E.y..i£#�iE7E�Y�3�'.%�1(If'i.ifif�!Eit�X�Y..ii.l�."'Dfi:�Y': � 'L O iv i N G R E Q t5 i R c N; E N T S S E i& A C K 5 ---------- ,�lAIN BlISLDSNG ----'------- ------�-- ACCESSORY 3F7ILDING ---------- FRNT: FT IN REAR: FT IN eRNT: FT 7:N R�AR: =T IN I,EP'P: FT IN RGHT: i'C ' SN LEhT: :"]` LN RGHi: FT IN PARKINC; REC�; PROV: PARCE%� 4180f324fi ZNc: RE� A�U: Pi�ki�NiiVl; NC)SES> ' y -- iE-N� if �1F i4 iE IE>�'. 3E 3(� a=# ii� #� i# ir ii iE d(� 34 i'r #'iE iE ii� N if iE i%iE if ii� �%� 3i iE iE 7E �k �I4 iF>',e f�- 3i- ii� 3e }:�.3f �i�-)E 3E �(� u. M� N� iE M 3 ii M� K�'4 s; R� #- k i'r �7i� �1[� k%�:� K� a:.%. #?'t ±i� Y D.. V E L O P M i Iv T S.. R V 1 C E S= :t �(;,i �J 1:t r, i� 1 r N i.-, 70N1NG APPiiClticD f3Y � � ilATc.: BCIILDZNG APP�OVED HY ;_ _ DAT�; _/�� _ _ APPI,ICATInN ISStJED �3Y: � � IATn; %%._2Q/ �// if #� 3i �� 3E 74 it iF i63i IE li� 14 i{� i'r �f iF 3!� if Y�Y.� if-Se"F'T'e �'3:- :�� .-'. £- Ir F'� fF fF�4 �iF?r'�iFiCN�R�T'r-3�� Y�1':i%if a'. X..N_?i 1:� i@ �Y� �E !i�%ii- iF 3't ir 3� .: �:: F++�.k'. 1fii�N�3EiP�lfiFtikui(#c#�Y�H�ifXi:�3�:�(-#�3FRik3(�}:#ielfii�7i�ii�s:�Ivii�IM1�(�3Eit1F�i�Y.-�'K�K� i't#!Fii�ii�iEY��%�iFif}:-#lfac#�f�it�ifliY'fi�N�M�3f3'r'r�-k#�}.`3i�iFr?t LEGALS7ATZON;N . E E S D M,. A R Y ST'RuCT:7�AL'SEGMSNi;�� PE�MIT �iDG PHT PT,i1NBI�G� F'LcCT�IC: . NcCHA�iiC FIR� SN.IP/�nS Gi2.�u7iNi: 25a" sMIP/NON-Rr.S PI�AN • ISSUE 'r'cE � -3,0@ ` F3TlII,DZ�G-llTV-> Pn't,2MZT ISSUE Fi,AiV-CHi:Ci{ TQTA.L PAID Du=' TOTALS--�-> 1.00 3,00 =- O.UO �.00 , 5,00 � ,00 REVENUL ASVTSZQN iQTALS--> eoii;r.CT;ED: �.00 O�JcR/SriQRT: 00 �iLDt; FNT Pi,UM3Ii�IG EZnCTRIC ME(.i3AN1C F3Rn S�IP/'iOT Gi�.ADING PLA�-Ciiri:Y .CJ'.�0 '. ' ' 3f %� �i!!� Y� iE iF ii� ii� % IF �lf R%i: -k� li� 3i ii� N� IF ih K�±. if it 3i� �X.• b:� #' 3f * iE :M ie 1(� ?:` h'.• ,'4 ie �i� }}. A� �` 7'r ii� k?P� } lc IF v- k� it� ii��! <�lf �k i�i 3F N� �.� ?i }i �.Y' ?r 3!� ?? li� y:� �#: iE k ik i� # fi ' � I N D I V I D?i. A L "r' � r 3 R E A Y. U O w N ?'YPE CtTY�^.�' D n 5 C R I P T S O' N UNIT C1�5't,' TOTAL �OF,'T PI�U 1 DIS3WASKnR f: 'L.UO 2.Q0 ! ;r.NU Or � � ES .1 2 6 �i ui�u�ii�s�"L�i�:7-U:Y: �+.:, i ��z¢: e;;aoi9+ T�r:F. _. _� �, - CONSTRUCTION AND PLANNING �' POO. . SPA � s APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector R. 1. Temporary Electriwl 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. APAROVAL TO COVER�GUNITE ' 7. Footings ' � 58. Electrical Conduit�Undrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. <_ t � 60. Backwash Lines, P�Trap, O Undrgrnd. �� 10. Structural Floor System Z " 67. 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. �ough Plumbing ' 65. Electrical-Final . 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring ' 67. Fencing & Access Approval � 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING , 78. 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 OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing , 73. Undergrnd. Storage Tank O Gas ❑ Oil �� 25. Roof Sheathing 74. Oveihead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM F1NAL 29. Insulation __.\ . 78. FIRE PREV. FINAL 30. Drywall Nailing � . HEALTH DEPT. REQUIREMENT i • 31. Plaster Brown Coat '� 79. FINAL INSPECTION �. 32. Electrical Power MeterFinal - 80. FOOD CERTIF�CATE ISSUED 33. Final Electric ' / Notes: �j /O 9( �OOhIKFIONI�-[,I�,FJ'(,qeO. �,,�p 34. Final Heating & Air Conditioning (� � 35. Final Gas Pipe•Test � ' � . . ' 36. Hood or Canopy ,y ; � 37. Final Factory Fireplace ._ .�� 1 38. Final Plumbing '7/��j � G£(� ' . 39. Water Service�Final 40. Gas Service-Final 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation • � 44. Landscape Irriqation SYstem , � 45. Sound Attenuation 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING ..� 48. FINALPLANNING '_il � 49. Electric Release to Edison , � 50. Gas Release to Southern California Gas Co ��' 51. CERTIFICA7E OF OCCUPANCY � � • No. pate � r nooness: 919 LOMBARD CT owi s NaMe: SHEAMAN MARY JANE ' ADONESS: 91 C� LOM�ARD CT �� COSTA MESA,CA 92626 AflCM/ENGMEEB: AOONESS: HEG.NO.: uxir: UNIT: eenmirr[e: gILT—WELL ROOF AND MATERI t 719 ) 739-1288 noon¢ss: 3310 VERDUGO ROAD Lt�S ANGELES CA 90065 LICENSEO CONTFACTOX OELLAXATION: I here�y affirm ��at I am Iicen5e0 unUer Owvisians of Chap�er 9([ammencing wiN Sec�ion 7000) ol �ivision 3 0� Ihe Business an0 Pmie55ion5 CoOe. ana my license is m fullforce antl eflect. ciTruc.: 039076 STATELIC.:4SHOOJ C 39 EXP; OS/95 �ale: �/(��_ Signaiure: —, � WOflNEPS' COMPE SATION OECIABATION: I hereby afiirm th I certiticaie oi consent to seli�insure or a certificale of Workers' Compensalion Insurance. or a certilied coDY thereof (SecVon 38 , Lab C) eoucrNo.: W937102489 E7(P.OATE: O%/S3/9S comrnxr: CAL COMP ❑ Cenilietl copy is hereUy lumishetl. d: Cenilietl copy is tiled wi�h �he cily BuildinA Oivision. Daie: ADPlicanC EXEMPTION FflOM WOflREPS' COMPENSpTION UECIAflATION: QhiS seCtion neea nol be tompleted i� the De�mil is tar one hunOred (5100) or less�. I cenify Iha� in the perlormance of t�e wark for whic� �his permi� is issuea, I II noi employ any De«n in any manner so as �o become sublecl to the Workers' ompensalion Laws of Califomia. � Da�e'. %�/ SignaWre: NOTICE: II. alier making ihis Ceclara�ion. yau shoultl bec e SUDIe e Workers' Compensation provisions o� �he Labor CoOe. you musi �otlhwilh comply wi�h such provisions or �h it shall be deemetl revoke0. CONSTPUCTION LENOING pGENCY: I here�y affirm Ihat Ihere is a constmction lentling aAency �or Ihe pedormance ol �he work br which �his permi� is issuetl (Section 3097. Civ. C�. LENOEH: FDOflE55: OWNEB BWLOEB DEClA8F710N: I hereby alfirm Ihal I am exempt imm the Coniractors' State License Law for the following reason �Semion 703L5 Business anA Professional Code: Nny ciry oi counry w�ich requires a permit to conshuct, alter, im0�ove, demolish, or repair any slmc�ure, prior lo i1s issuance. also requires Ihe applicani lor such permi� to file a signetl s�a�ement I�a� he/she is licensed Dursuan� Io Ihe O�ovisions o� ��e ConVac�ors' Sla�e License Law (C�ap�er 9(commencing wi�h Sec�ion 7000) of Division 3 0l ��e Business ana Pm�essions Cotle) or Ihai �e/s�e is exemp� Iherefmm and the hasis for ��e allegeU exemption. Fny violaiion of Section 7031.5 �y any applican� �ar a permii suDlecis the aDPlican� Io a civil penal�y o� na� more Ihan �ive huntlretl dollars (5500). I, as owner of the pmpeny or my employee5 wi[h wages as t�eir sole campensa�ion, wili tlo Ihe work, anJ �he ❑ stmaure is not intenAetl or oifereE ror sale (Section 70a4, Business an0 Pmiessional CoOe: The Contractors' State license Law tlaes noi apOty ta an owner ol a property who builtls or impmves Iherean, and who does such work himselt/hersel/ or ��wugh his or her own em lo ees rovided Ihat such im mvemenls are not intenEed ar oflered tor 5ale I� however �Ae Ouiltling or CITY OF COSTA MESA — BUILDZNG PERMIT PERM NO; b 067975 PERMIT NO: B 0679"IS PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/OFF & AEROOF WITH COMP. E BUR IN BACK SQ FT: 1,100 CLAIM VALUE: 1,100.00 r_ALC—VALUE: 1,100.00 GROUP OCC: R-1 /M-1 COMMENTS; SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM 6 HALLWAY �r�****+�rt��r�+t**�tr�*��*�€�r�r***�r*�r�r�r*�**�+r+�**��r�t�+�***�r##+�***x�rx*��*�r*�r�t��*�*�**x-* Z O N I N G R E Q II I P. E M E N T S � S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- 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: PR��V: PARCEL: 41808248 ZNE: REF NO: PLANNING NOTES> -:. > x�*******�r�ct�*�x�r***+�*��r***�r*�r**�r*�r***�r�c+�**�***�xx�t*��c�+��r�*tt��rx�*�***u��*x*��*��t D E V E L 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: BUILDING APPROVED BY ; DATE: f`' APPLICATION ISSUED HY: / � DATE: �_� � �. i��EiF1t3E�%iFiEx-�(iE�:�7E�f;ltifKiP*�F3E* � ,r � .�:yv—,� wja�«�tr��rrrr�Fi x�Trrr,r�r;E�iEi(1�iElEiE3FjE�' vr �F i�/iFiiltY �lE##iFif#iR�N�#ifiE3EiFifiEiF3E3(iFii�9F9:jEic�ifit�iFiF�lfii�%i[�3FT:�iFif-1FiEiFiEiflEifiFifitiFi4'KiEie?iiF#�FiEaEiFifN�'1E3fiFiEifiEiEiEiFiE�4�1F�1tiE fit3fjFif LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT FLUMBING ELECTRIC MECHAAJIC FIRE SMSP/RES GRADING PERMIT 27,00 .50 PLAN ISSUE f'EE BUILDING—DI��—> TOTALS----> PERMIT ISSUE PLAN—CHECK TOTAL 27.50 0,00 0,00 27.50 SMIP/NON—RES PAID DUE 27.50 .00 impmvemem is som wimin one year oi compleiio n. �he owner wiu have �he 6umen oi Omving he/sAe ditl no� build or improve R E V ENUE D I V I S I ON TOT1�L S--> COL L ECT ED : 2 7. 5 U O V ER / S HORT : . 0 0 ro��nePurPosea�sa�e). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRALIING PLAN—CHECK I, as owner oi Ihe pmpertY, am eeclusively canirac�ing wi�� licensed conlraciors Io con5imc� �he pmlec� (Sec�ion 70C4, Business z%. � � , eJ � ❑ andPwfe55ionsCode: TheCon�raciors'SlalelicenSeLawtloe5notaDPly�oanownerolpmDertywhobwltl5orimproveSlhere0n andwhocOnlrat�5br5uchproleCtSwi�hatoniraC�or�S)litensepur5uan�loth¢ConVaciors'Sta�eLiCenSeLaw�.lamawafe *.*.x.ii.iEiFiEif..x.3f.i(..x.*.NiE.�.kiC..x..H.fI..X.lE.K..k..y�{E.k.�c**.X..x.*{Fi(..1F.1t.N.#.A..x,.x,*.l�i(,.IEiE.�i(,ffiF#eiE:h�F.K.,M,�%.�C,.%.*,x,�C,il,*,�F,x,il,if„x„x,.H,},K„�*�. iha� pmaf o� meir Worker's Compensa�ion insurance shoul0 he provitlea �o me. I N D I V I D[I A L F E E B R E�, K p O W N � I am exemp� under Section: B. & P. C. �ormis�eason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST oaie_ owner. SFR 1100 P.EROOF BY VALUE RESIL�ENTIAL NOZONE 1.00 1, 100.00 I do hereby cenily ihat I am aware ol ana understand Ihe requiremen�s of Calilomia Health antl Safery Cotle Sections 25505, 25533, and END OF FEES 2553d antl Ihal I or any fuNre 6uil0ing occupan� will/will nol (circle one) neetl �o compty wiih saia Slaie co0e5 antl ��e repuiremen�s for a permit lor con5lmciion or modificalion trom �he Nir Oualily Managemen� OiSVicl Resitlential cons�mction apDlications are eeempt �mm Inese pmvisions. �a�e: Fpplicanl: I h¢reby certity ��al I have reatl Ihis apPlicaiion and stale Iha� �he above in�orma�mn is correcL I agree Io comply wi�h all ciry and counry orAinancesanOSlatelawsrelaling�obuilemgconslmc�ionandherehyauthorix resentalivesof�hiscitytoenierupon�heabove-mentionetl pmpetly �or mspedian purposes. Oaie: 7/V/Q`� Signa�ure: — �river'S License or Social Securily a: ��' � � t6aba6 Whne—Builtling�, Green—Gotle Enlomemen��, Canary—Applmanl; Pink—Fevenue; Goltlenroa—Assessor V OI 4D163723-00163723 T��T �7,50 DATE: D7/1]/94 TIl1E: 11:0` + POOL ,PA �C,ONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector pppROVALS Permit # Date inspector 1. Temporary Electrica( Serviceyi. Pole �: 52. Poo1 & Equipment Location 2. Soil Pipe-Undrgrnd. % �� 53. Steel Reiniorcement � 3. Electrical Conduit Utility-Undigrnd. 54. Forms � 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcemen; 56. Rough Plumbinq & Pressure Tzst 6. Electrica� UFER Gmd. 57. APPAOVAL TO COVER-GUNITE J� 7. Footings 58. Electrical Conduit�Undrgrnd. j 8. Foundation � 59. Gas Pipe. � Undrgrnd., Test �--� � 9. VJater Pipe-Undigmd. '� j� i � 60. Eackwash Linet, P�Trap, L�. Undrgrnd. r;' � r 10. Structure� Floor Sysiem � 61. APPROVAL TO �ECK �"�r� �, 11. Property Sewer Line & Hou� Connection ' " 62. Backwash & r�eceptor�Final ' � 72. Sewer Cap ' . �`�� 63. Heater & Vent•Final `' . 73. Roof Dra�ns 64. Plumbing System - Plnai �_,; 74. Rough Plumbing 65. Electricai-�inaV �.� 75. Rough Electrical�Condu�t 66. Solar SYstem-Final f! 16. Rough Electric Wiring 67. Fencing & Access Approval 77. Rough Wiring Sign 6S. APPROVED FOR PLASTERING ` I� 78. Rough Electrical�T Bar Ceilinq 69. POOUSPA SYSTEM1AS FlNA� 19. Rough Heating & Air ConditSoning FIRE DEPT. REQUIREMENT 20. Rouyh Factory Fireplace � APPROVALS Permit �r 21. Oucts,in Structure 70. Unde:ground,Hydro 22. Ducts, VOntllatin4 71. Product P'iping C Gas G� Oil 23. Ga5 Pipe�Rough & Tes. 72. Underground Flush � 24. Roof Framing 73. Undergrnd. Storage Tank Q Gas ❑ Oil 25. Roof Sheathing 7.,(Y�U (Lw� 74. Overhead Hydro I l 26. T�Bar Ce�ling (Struciural) & Monocoat 75. Dry Chemical 27. Frame and Fiashing � 76. Dry Standpipe � 28. Laching & Siding . - 77. FIXED SYSTEh1 FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing � HEAl7H DEPT. REQUIREMENT 31. Plasier Brown Coat 79. FINAL INSPECTION � 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. final Electric Notes: - 34. Final He3ting & Air Conditioning .� 35. Final Gas P�Pe�7est , � - 36. Hood or Canopy � 37. Final Fattory Fireplace � 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 47. Solar pomesticFinal , 42. Backflow P�eventer 43. Backflow Irrigation 44. Landsca0e irriGatlon System 45. Sound Attenuation . � 46. Handicap Regulations 47. f WAL STRUCTURE & 6UILDING .,��_qK 6�:�' � ' 48. FINAL PI.ANNING '" - - 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTiFICATE OF OCCUPANCY No. Date