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Home My WebLink About921 LOMBARD CT - Building PermitsCITY OF COSTA MESA sva��N6 ��v�s►oN DEVELOPMENT SERVICES DEPARTMENT PERMIT ��ia� �sa-sva • Fax pia) �sa-aess - JobAddress: 921 LOMBARDCT Suite No Vlcinity: Parcel Nunmber: 41806250 Applicant: ALLEN, MARK Address: Owner: LIZZI, JAMES A Address 921 LOMBARD CT COSTA MESA, CA Contractor: PROSERV PLUMBING Address: 3042 ENTERPRISE UNIT F COSTA MESA, CA ArchlEng: Address: PLUMBING PERMIT Phone: Zip: Phone: Zip: 92626 ��:� Phone:- 714-5d0-2253 � Zip: 92626 . , . License' 467194 � Phone: Zip: License: SCOPEOFPERMIT , . WATER HEATER CHANGE OUT FOR SFD. = �! � ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Conned (Ice,Soda,elc) Denlal Unils Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 ouNets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 So.00 $0.00 so.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY _ _ - , r,Mr Qrr Laundry Tub / Washer � $0.00 0 Landscape Irrigation . $0.00 0 P-Trep � � � $0.00 0 Pressure Regulator $0.00�' 0. Process Piping.(per 10 ft) � $0.00. � 0,,, Receptors $0.00 0 � Septic Tank _ ' �' $0.00 0, • Sewer Cap tor Demo � .` $0.00 . 0 w 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� 0 Spa (public) - $0.00 0 COMMENTS I SPECIAL CONDITIONS NUMBER P99-00273 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 05/11/1999 Issued: OS/11/1999 ISSUED BY: Sump Pump Swimming Pool �Trap Primer Urinal Vacuum Brkr Bkflow(1-0) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe . Water Service Water Softenei OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $o.oa $0.00 $0.00 $0.00 $11.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 TOTALCALCULATEDFEES: $33.00 orv 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomie 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 penod of 1 BO 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 requlred inapectlons end finel epproval must tie obteined. Feilure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS'COMPENSAnON DECLARAnON: _ I hereby aflirm untler penalty ot perjury ona of the following Aeclaretions:' � ❑ I heve end will maintain a certiticate of consent to setl-Insure for workers' crompensation, as provided for by section 3700 of the Labor Code, for the peAortnance of t�e /'^�ork for whlch t�is permit I9 issued. N]' �I have end will malntaln workers compensetion insuranca, as requireC by section 3700 of ihe Labo� Code, for tha pertortnance oi the wwk tw which this pertnit I5 issued. My wo c,e..r/�_',.c.�npens en Insurenc�a,Q�6�rrler �end olicy number ere: // /� (1 // ,�1ary�,v Carrier: � /U/r �r7��w�f�i�9G//O.— 1inSd/d�lCe- �wC . . Policy Number. �� % 7 UH• (Ywws2� (This sectlon need nof be campl d i! the permif is velued et one hunUred tlollers ($100) or less.) ❑ I certity ihet In the DeAortnence of the work for which this permit is issued, I shall not employ any person in any menner so as to become subject lo ihe workers' compensation laws oi Califomia, an gree t et it I shoultl become subject to the workers' compensetion proNsions of Section 3700 of ihe Labor Code, I shell forihwlth wmD�Y with these vi i ns.// ApplicaM SignaWre:��/ � �� Date: �j�� r WARNINO:FNLURETOSECUREWORKERS'CAMPENSATIIXJODVERAQcISUNUWFULAN�SMALLSUfl1ECTMlEMPLOYERTOCRIMINALPE TIESANDCMlFlNESUPTOONEHUNDRE� TqUSAND DOLLARE (5100,000), IN ADDfTION TO TME COST OF COMPENSATION, DAMAGES AS PPOVIDED FOR IN SECTION 37060F THE LABOR COOE, IPfrEREST, AND ATTORNEI^S FEES. LICENSED CONTRAC70RS DECLARA710N: I hereby attirtn thet I am Ilcensed un er provisions of Chepter 9(commencing with Section 7000) of Division 3 of the Business�nd Pro�essions Code, and my license is in full �orce antl eftect. Lic. M �/�'7�95i - aa� a C� CONractofs Signature: � Date: �� CONSTRUCTION LENDING AGENCV: ❑ 1 �areby afflrm that Ihere is e conswction lending egency tor the peAormance oi Ihe work tor which this pertnit Is issued. (Sec. 3097, Civil Cotle). Lentler's Neme: Lendefs Address: Signeture: Data: OWNER-BUILDER DECLARATIONS: I hereby ettirtn ihat under penelry ot per�ury that I am EXEMPT FROM T}iE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business entl Professions Code: Any ciry or counry which requires a pertnit to construd, alter, impmve, demolish, or repelr any structure, prior to its issuence, also requires Ihe applicant tor such permit to file a slgned stetement Ihet he or she is licensed pursuant to ihe provisions af the Coniractars License Lew (Chapter 9(commencing wlth Section 7000) of DMsion 3 ot the Business antl Proiessions Code) or ihet he or she is exempt theretrom and the basis for the alleged exemption. Any violation of Seclion 7031.5 by eny eDP��ent for e permit sub�ects the epplicent to e civil panelry of not more than iWe huntlrea tlallars ($500)J: ❑ I, es owner of the property, or my employees with weges as Iheir sole compensetion, WILL DO THE WORK, entl the atructure is not Intentletl or ofrered for sale (Sec. 7044, Business and Prafessions Cotle: The Conirectors License Lew does not epply to en owner of properry who builds or improves thereon, and who does such work �imself or herself ar through his or her own employees, provided ihat such improvemenis ere not Intendad or oNered for sale. It, however, the bullding or impravement is sold within one year of completion, the owner-builder will have Ihe burden of proving Ihat he or she did not build or improve for purpase of sele.). ❑ 1, es owner of the properry, em EXCLUSIVELV CON7RAC71NG WITH LICENSED CONTRACTORS to consiruct Ihe proJect (Sec. 7044, Business end Protessions Cotle: The contrectors License Lew does not epply to en owner at property who builtls or improves ihereon, end who contrads for such pro�ect with e coniractor(s) license pursuant to the Contractore License Laws.). ❑ I am e:empt under sec. Business antl Professions Cotle for this reason: Signawre: Date: Owner ID verified by drivers licensa. ❑ Yes ❑ No Dnvers License No. Venficatlon of Ownershlp by (type of document, I.e. - properry tex bill or deed): DIVISION OF INDUS7RIAL SAFETV PERMI7 CERTFICATION: Ezpires: ❑ I hereby certity that no excavetion five (5) or more feet In tlepth into which a person Is reqWred to tlescend, will be matle in connection with work authorizetl by Ihis pertnit, end t�at no building strudure, scaHolding, falsework, or tlemolitlon or dismantling thereof, wlll be more than thirty-siz (36) teet �igh. (Chap. 32, Grp 2, Art 2, Sec. 341, Title e, Celifomla Atlministrative Code). ❑ As owner-builtler. I will not employ anyone to do work which woultl require a permit hom the Division of Indusirial Safery, as noted above, unless such person has a permit to do such work from ihe division. _ ' Signature: Dete: DiWsion oi Indusinal Safety Pertnit Number: CERTIFICATE OF COMPLJANCE AND AUiHORRATON OF ENfRV: I certity under penalry of perjury lhal I have reatl this application and steta that the intormation given is wrrect. I agree to wmply with ell stete lews end ciry ortlinances relating to building constnidion, and authonze representatives of ihe Ciry of Costa Mese to ente� upon the above-tlescnbed property for inspection purpases. I agree not to occupy or allow occupancy of any builtling authodzed Dy thls permit until fnal inspection. �siynat e Of eg er(s) �/// ate �„ �� ' L� i AnNOr Authonzed Applicent Date COUE I. INSPECTIONTYPE 1616 Fi:etl System Final Fire Prevention 1266 Pool Spa Finel 200 Flnal Re-Rool � 201 Final BIocWRetelning Well 202 Finel Factory Fire Plece 203 Finel Sign 204 Final Demolition 2M6J8 QSjE jy$J�$ �QQf�� INSPECTIONTYPE 206 Final Mechsnical 208 Final Plumbing 210 Final Electricel � 212 Final Fire Preventlon 220 Finel Planning Approval � 222 Finel Site 250 Finel Building/Occupancy PAIE 1NT�94$ CZL�/� TRACT NO.��qqr, DATE .li�l� 91 1QR� '�� . .u.. . . . u- � • 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 co�on areas be3.ng completed and,accepted by the City of Costa Mesa. � �0 , ��'� � BY iIiYIA� e ,��, �i� � (SIGNATURE OF PURCNASER) � REPRESENTATIVE) C��6��°� oF cosr,� i��s� n��tOPMENT SERVICES GEP�IRTME�V� �M= `�ll� 2 4 1980 ��g�g+1(1:lJi(2,1�2i3iq�s �' � � PflOJECT AUGHESS: �j z Z LOMBARD L T OWNEfl'S NFME: L I Z Z I, JAMES A i aoowyss: g z 1 LOMBARD CT '� COSTA MESA, CA APCH/ENGINEEfl: ADOflE55: UNIT: 92626 XEG.NO.: UNIT: PEflMITiEE: BILT—WELL ROOF AND MATERI ( 714 ) 739-1288 aooRess: 3310 VERDUGO ROAD LOS ANGELES CA 90065 LICENSED CONTBACTOB UECLABBTION: I hereby aifirm that I am licensed under pmvisions o� Chap�er 9(commencing wi�h Sec�ion 7000) ol �ivision 3 ol Ihe Business an0 Pm�ession5 Cotle. and my license is in tull �orce anJ eflect. cirruc.: p�qq�g STRTEIIC.:L�jAOO`J i' 39 EXP; OS/95 Date' ��;�—_ SignaNr ' WOHREflS' COMPENSATION OECLAPATION: I hereby a�� Ihat I 1 cenificare of consent to seu-insure ar a certilicate of workers' Compen5aiion InsuranCe, or a teriilietl CODY lhereo� (S¢ctl . Lab. C). roucvNo.: W937102989 EXP.OATE: O%/13IJ4 comraxv: CAL COMP � Cenilied topy is hereby lumishetl. �. Cenihetl capy is liled with �Ae City Building Divisi0n. Dale: AOPlicanC E%EMPTION FNOM WOFNEBS'COMPENSPTION �ECIAflATIQN: (TAi55eClian neetl not�eComple�eAiflAe permitis brone hunCr¢e($100�orles5�. I cetlity �hal in lhe performance bl Ihe work for which ihis permit is issued. I �¢ mploy an person in any manner so as to Uecome Subleci �o ihe Wo kers' ampensation Laws o� Calilomia. Oate�. � l Signature�. NOTICE: I1. ai�er making I�is aeclara�ion. you shoul ec ' e Wo�kers Compensation provisions of ��e Lahor Cotle. you mus� lorthwith comply wi�h suc� pmvi5ion5 or �his permit shall �e tleemetl revoked. CONSTHOCTION LENOING AGENCY: I hereEy aflirm I�at Ihere is a cons�mction lending agency tor Ihe petlormance of the work �or which Ihis Oermi� i5 i55ue4 �$¢C�iOn 3097. Civ C�. LENOEfl: ADDNESS: OWNEF BOILOEN DECIAHATION: I herehy aftirm Ihat I am exempt irom Ne Contracrors' State License Law for the followinA �eason (Seqion 7031.5 Business and Prolessional Code: Any city o� counry whic� requires a permi� lo cunstrucl, al�er, improve, tlemolis�, or �eoair any stmc�ure, prior ta its issuance, alsa requires �he applicant for suc� permit lo lile a signetl slaiement �ha� Aelshe is Iicense0 pursuam �o Ihe pmvisions ol lhe ConVac�ors' S�a�e License Law (C�apter 9(commencing with Sec�ion 7000) of �ivision 3 0� the Business antl Pmlessions Code) or �hal �e/she is eremp� Iherefmm anA ihe basis lor Ihe alleged exemption. Any violation ol Seclion 7031.5 6y any applicam �or a permii suhle��s t�e aODlicani to a civil penal�y of nol more �han live hunGred dollars (5500). I, as owner o� ihe pmperty or my emyloyees wilh wages as �heir sole compensation, will do �he wo�k, antl Ihe ❑ simcWre is nol imenEetl or oflereE �ar sale (Section 704a. Business an0 Professional Cotle: TAe Contractors' State License Law tloes not aDPly to an owner ot a O�oOany who builas or impmves ihereon, anA who Oaes suc� wo� himsell/herseli or ihmugh �is Or her own empl0yee5, provideU �ha� SUth imprOvements ar¢ nol intentle0 Or oflefed (Of Sale. If, how¢ver fhe builtling or impmvemenl is soltl wiihin one year oi comple�ion, �Ae owner will �ave �he 6urden o� DmvinA he/s�e tlitl no� builtl or improve , lor Ihe purpose o� sale�. I, as owner o� the pmperty. am exclusively coNracting with licensetl caniractors to coretmc� �he pmjeci (Seclion 7044, Business ❑ antl Pmiessions Cotle'. The Con�mclors' Sta�e License Law tloes not appry �o an awneroi pmpe�y who builtls or impmves �hereon antl who conVacts lor such pmlect5 wi�h a con�rac�m�s)license pursuan� Io Ihe Conlrac�orY Sta�e License Law),I am aware I�al pmoi ol �heir WOMer'S ComOensation insUrance ShoWd be pmvitled Io me. � I am exempi untler Section: B. 8 P. C. for ihis reason: �aie: Ownec I ao hereby certi�y Iha� I am aware o� antl untlerstantl ��e requiremen[s ol Califomia Health antl Safery Code Sectiore 25505, 25533, antl 25534 ana tnal I or any Iuiure buil0ing occuoan� willlwill no� (circle one) neetl �o comply with saiG s�ate codes anC Ihe requirements �or a permit lor constmc�ion or moaification imm �he Air �uabry Manaqemenl �iSVict. flesiden�ial construc�ion applications are eKemp� fmm ihese provisions. Dale: NOPlicanl: I here�y cerlity thai I have rentl Ihis apPlicaiion antl Slate that ihe above in�orma�ion is correct I agree �o comply with all city antl couniy ortlinances antl staie laws relaling to �wl0ing constmdion antl hereby aut ' wep entativ of this ciry to enter upon the above-mentione0 pmperty loi inspecti n purp ses. Dale: S'onaw e' �river's License or Social Securily x: —. �,� . �� t641�46 While—BmlOinq; Green—Cotle Eniorcemenl', Canary—AppllcanC, Pink—Fevenue: Goltlanrotl—Assassor CITY OF COSTA D1ESA — BUILDING FERMIT PEAM NO; B 067977 PERMIT NO; B 067977 PLAN CHECK NO: N GOVT: N SOPP; N CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION ; T/OFF & REROOF WITH CONIP. 6 BUR IN BACK SQ FT: 1,100 CLAIM VALUE: 1,1OQ.00 CALC—VALUE: 1,100.00 GROUP OCC: R-1 /M-1 COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM 6 IiALLWAY *�r��r**#***�r*�c-*K*****�-��******�: *x x�c�� **��r�****�r*�*x��*******��;-*�*�***�r#*�*�**x* Z O N I N GS ERTEB�AUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN AEAR: FT IN LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41808250 ZNE: REF NO: PLANNING NOTES> > iEXiEk3EifiEiFiEi4#iE#ibft�lEiEkiEiEiEiEiliEiEiPiEiFiliEitiEiEiFlFiFiEiFiEiEit3EiFiFiEic#iEiEiF3EiEfEiEjEi6iEiFiFifiEiEiEiFiti£it1E ' iEiFi'iEiEi(iEjf9@ 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'� S ZONING APPROVED BY DATE: BUILDING APPRO��ED BY ; DATE; �} APPLICATION ISSUED BY: �L DATE: �� c�*x***�*��*��,=*��x**�r �- -�x,� - ��*�*�***�r3��-€F��** *r�**�r�*��-*�***#��*�***�c�*�**�****�*��**�*******xx***�r�*x*��cx**�x*.:*�cxr�r�'***r LEGALIZATION•N � � . F E E ti U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECIIANIC FIRE SMIP/RES GRAI7ING PERMIT 27.00 .50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> [�ERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 27,50 0,00 0.00 27,50 27.50 .00 REVENOE DIVISION TOTALS--> COLLECTED: 27.50 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GAADING PLAN—CHECK 27.00 .50 # �Fll� fE if iE iE X-it 1E 1E if iF iE 1t �)E iF i! #�F iF iE iE iF 1(-if i(� iF ik i4 ik iE jf iE iE iE iE iE �1E i6 ik iE iF i(� iE iE if #' 1F # it ## if iE iE ie jE i! 1h # 9F iE #�7(-�E IE if iE # iF iF iE �IF'1F-Yl-% 3E 16 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 COST SFR 1100 REROOF BY VALCIE RESIDENTIAL N020NE 1.00 1,100.00 END OF FEES O1 00163726-00163727 Tr]T DpTE: 17/11f94 TI17E: 11:06 V ?7.50 CONSTRUCTION AND PLANNING POO� .cPA A�ROVAIS Permit # Oate Inspector qppROVALS Permit # Date lospector t. TemporarY Electrical Service`or Pole 52. Pooi & Equipment Locatton �� t - 2. Soii Pipe�Undrgmd. �-� 53. Steel Reinforcement "��:: 3. Electrical Conduit Utility-Undrgmd. 54. Forms '�' 4. Electrical Conduit-Undrgrnd. 55. Elecirical Bending 5. Steel Reinforcemenc 56. Ruugh Plumbing & Pressure Test • i 6. Electrical UPER Gmd. 57. APPflOVAL TO COVER-GUNITE � 7. Footings ' 58. Electrical Conduit�Undrgrnd. � . 8. Foundatiun � 59. Gas Pipe, I� UnUrgrnd., Tesc i 9. Water Pipe�Undrgrnd. j� � 60. Backwash Lines. P�Trap, � Undrgmd. � �%� t�. Strucwra� Floor SYstem `� �% I��J 67. APPROVALTO DECK � %�� 1 i. Property Sewer Line & House Connection '� . 62. Backwash & Recep.or�Final ��. '� _J �, 12. Sewer Cap � �� , 63. Heater & Vent�Final J� 73. Root Drains 64. Plumbing System - Final �' 14. Rough Plumbing ' 65. Elec!rical-Finai ..� 15. Rough Eleccrical-Conduic 6fi. Solar System-Final ' 16. Rough Electric Wiring 67. Fencing & Access Approval y 17. Rough Wirin9 Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEA,�S PINAL 19. Rough H¢ati�g & Air Condi:ioning F4RE OEPT. REQUIREMENT 20. Rough Pactory Fireplace � APPROVALS Permit � 27. Oucts, in Structure ' 70. Undergrourd HYdro 22. Ducts, Ventilating � 77. Product Piping G' Gas Q Oil 23. Gas Pipe�Rough & Test 72. Undergroi�nd Flush 24, Roof Fram�ng 73. Underyrnd. Storaye Tank � Gas ❑ Oii 25. Roof Sheathing 7'��.�' Gp„6/ 74. Overhead Hydro i 26. T-Bar.Ceilin9 (Structural) & Monocoat 75. Dry Chemicai 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insuiation - . 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH OEPT. ftEQUiREfv7ENT 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Elec2rical Power Meter�Final 80. FOOD CERTIFICATE ISSUED i 33. Final EleCtric Notes: ' f 34. Finai Heating & Air Cond�tioning 35. Final Gas P�Pe-Test - 36. Hood or Canopy ^' 37. Final Factory Firepiace 38. Finai Plumbing 39. Water Service-Pinal 40. Gas Service-Final 47. Solar OomesticFina� 42. Backflow Preventer � 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STliUCTURE & BUILDING �.. /_irL< �! � 48�. FINAL PLANNING . � 49. Electric Release to Edison . � 50. Gas Release to Southern Catitornia Gas Co , 51. CERT�FICATE OF OCCUPANCY • � No. Date , OWNER BIDDLE DEVEIOPbSQVT INC. JOB ADDRESS , , m ar oF DATE 7-13-79 SUBCONTRACTOR Gn5 WRTER ROUGM PIUMBING PROP. SWA� LiNE ROUGN NE/•TING AND AIR CONOITIONING �' /��a �1- H�( - TEMPOR4AY SEAVICE OR POLE UNDERGROUN� � POWER G ' ROUGH WIA�NG Meoeii TRE4CHE$ FORM$ STEEL FEINF. � .� FLOOR SYSTEM {r BONO BEP� STEEL REIN CE � ' SMEATHING p'� �-loii- FRAME ANO FLASNING T -$� /� LATMING —=N OUT �� P i,BROWN COAT ,�, 5 JW>L, FIN4L � ,.- Q ME<iiNf. VENT.. FEFRIG. 1N0 i.L. FINAL �Ze G � � mr R' �� jnlSt.tQAfl�.� �R� c� r1 A; l �� Rol�lq I'31-$� �s a�ii-�.. � � �� !I-� ic. ��-E- /�'�K- �d''�°''`' /l-/�f-7S l�J6S�-` !l -rN • 79 � 70 93 � F � Ir] O. Q r�. y � F C w F G .� � � Q�i W � ai o. Z S 3 �85��J COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COS7A MESA, CALIFORNIA 92626 For Applicant to Fill in Completely - Use Ink Only BUILDING OWNER Biddle Development, Inc. nooAEss3848 Campus Dr. Suite 116 aTr Newport Beach, CA N�40-5505 CANSTRUCTION BRANCH ADORESS ORENGINEER Ladd,Kelsey,Wood�a��' ADDRESS 180 Newport Center Dr. NB coN-rancToa Biddle Development, Inc. nooRess 3848 Campus Dr. Suite 116 a-rv Newport Beach, CA No��540-5505 LIC. NEc$Z86614 ��CVNO. SIZE NO.OF BLDGS. _ OF LOT NOW ON LOT USEOF residential EXISTING BLOG. electric, plumbing and heating work. UILDING AND WORK TO BE PEFFORMED iit -0k 50 A 1284sq.ft. �k 51 C 1630sq.ft. �F 52 B 1450sq.ft.� I hereby acknowledge that I have reatl this applicaSion antl stata that the above Information is corract and ae�ee to comply wlth all laws regulating butlding construction, and 1 shell noi employ eny perwn in violation of the workmen's compensation laws of the Siate of California. 1 hereby cattifV that I em properly Iicensetl as a cont�actor untler the Stete of Calffo�nie Business entl Professions Code, Division 3, Chaptar 9, and that such licenses are In full force end�etfect, or I am exempt from the provislons of the Stan elifornia Business and Protessions Catle, Divicion 3, Che . Sipnature 'L--� � Per e i� -r AuMorized Agent ' %19%79 243.65 TL� BLDG. 4k ll -�--- - .._ ._ _ _.. _. -.. APPLICATION FOR STRUCTURAL PERMIT RECEIVED BV DATE RECEIVEO DATE ISSUEO. TRACT W ADD ALTEF F OWNER FIRE ZONE T APPROVED BV 7 o.oF PLANS VAROS APPROV ED VAR. PERMIT NO. DATE USE OF NEW� BUILDING VARDSAPPROVED ACCESSORY BUIIDING THE AMOUNT SHOWN UNDEF VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION PERMIT FEE $ AIV PLAN CHEGK $ 3�S $/ ��D(/ TAX E �' s TOTALPAID � N w � m (}�I• 'm 1 ` v� m (�l � � �� m e a � n, m �m o � LL � � � . s . ... ♦. � . . "!rC .. 359.00 TU COSTA MESA BUILOINGSAFETY DEPARTMENT APPLICA7'1 ,. TURAL PERMIT �NIYCJX�V RECEIVEDBV PERMIT N� 48431 For Applicant to Fill in Completely — Use Ink Only .BUILDING A.P. NO. ADDRESS BUILDING OWNER OR ADDRE55 TENANT VNIT OR MAI LI NG SPACE NO. AD�RE55 TR.NO. LOT BLK. TEL. CITV NO. NEW ADD ALTER REPAIR MOVING DEMOLISH CANSTRUCTION LENDEFi BRANCN OWNER ADDRESS ' LUE ARCHITECT TEL. � USE E OR ENGINEER N ADDFESS ZONE TYPE GROUP APPROVED CONTFACTOR. BV DATE ADDRESS TEL. CITV NO. STATE CITV APPROVEDSETBACKS LIC. NO. LIC. NO. ' SI2E NO.OF BLOGS. (FFOM C/L STREET) OF LOT NOW ON LOT RONT FT. USE OF EXI5fING BLOG. . Separate permits are required for L. SIDE FT. electric, plumbing and heating work: REAR Fr. VSE OF BUILDING AND WORK TO BE PEFFORMED , � pLqNNING ACTION DATE APPROVED APPROVED I hareby acknowletlge that I heve read this aOPlication and stata � that tha above informaiion is correct and apree to comply with ell laws regulating buildinp consttuction, entl I shall not employ any pe�son in violation of the workmen's compensation laws of the State of Celifornia. i heraby certtfy that I em p�Ope�ly licensetl as a coniractor untlar SQ. FT. � the State of California Businpss antl Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR i Chapter 9, and thet such licenms are in full force anG affect, or I THE PVRPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exempt from the provisions of the Stata o7 California Business VALUATION PERMIT FEE S � and Professions Code, Divisio� 3, Chapter 9. �.ii � � Signature of VLAN CHECK $ �^ Permittea $ � TAX $ �� or .. i Authorizad Agent Date TOTAL PAI D $