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Home My WebLink About900 19TH ST - Building Permits� - / � +�.e s� I�-fic' o-» � Fi �P i 'J G�.o-1�� , , ,� 3 �7 �`� I - �- a ° _ � �' ' ^' .:� C�STA MESA BUILDING DEPARTMENT �/ti��l Y'� / ��^ P. O. BOX 31� � 7 COSTA MESA. CALIFORNIA - / FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING w _ � BUILDING ADORE55 COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY _ / . �• i �_ NECEIPT NO. lPERMIT NO. MAIL AODRE55 IARCHiTECT OR E�"'NEER ICONTRACTOR LEG�L LOT �� DESCRIPTION NO. A.P. NO. .�. S��E__ -�� ` �EL.�I � NO. � � LIC. NO. i Fj CITY LIC. /t NO. TEL. NO. BLOCK TRAC NO. OF BLDGS. NOW ON LOT / • � SETBACK LINE FROM CENTER OF SiHEET EAft YARD SIDE YARD RIGHT � /� LEFT O' DESCRIPTION OF WORK NEW J�. ALTERATION AODITION REPAIla MOVING OEMOLISH BUILDING "/:�� / /�� NO.OF j / SIZE f� 7C tY� AOOMS STORIES EXTERIOR WALL ROOF COVERING COVERING � �\ � APPROVED BV /� .'�D� � � �� MESA. CALII IA DATE CORRECTIONS C�IL� �'- /{�/ - Sd' � : /.� C I HEREBV ACNNOWLEDGE TH4T 1 NFVE REAO TMIS APPLICITION ANO ST�TE TH�T TNE wBOVE IS CORNECT �No 4GREE TO COMPLY WITN /.�l CITY ORpINtNCES 4ND $TwTE lAW9 REGUTATING BVILOING CONSTNUC� TiON. VALUNTION PERMiT FEE S C t SIGNATURE OF � � � . /�' �� PERMITTEE ��l i bO pLANCMECK 5 �� $ -J�Ov` TOTAL FEE 5 �,• dU 9'�� AUTHORIZED AGENT •— � ' �s��. fD.e._.� ,� , � �lzc � COSTA MESA BUILDING DEPART� P, O. BO% 31'/ COSTA MESA. CALIFORNIA F/O�R APPLICANT TO FILL IN BUILDING(.f. n ._. //iT i'� COSTA MESA, CALIFORNIA >:r ,��'z��.m.r,� a w ��5� p�..'7^+t�F�p L` TN�j � O. O � _ LIC. I ADDn_..5 N� (\ M �/ CITV �E�� LOT � �O IBLOCN ITRACT/� oEscniviiorv NO. A.P.NO. S� ��D $12E � // NO. OF OLOGb. OF LOT O Now or+ �oi USE OF P E%ISTING BLDG. ` / IV SETB�CN IINE FNOM � CEniEn OF STnEEi � EAR YARD I / SIDE YARD RIGH� / � LEFT DESCRIPTION OF WORK � NEW A�TERATION AODITION FEPAi.. MOVING DEMOLISH BUILDING // NO.OF � 512E � 4 �ROOMS STORIES � E%TERIOR WALL ROOF COVERING COVERING USE OF NEW / O BUILDIN �y �� 6�1�� •�Gtl� L 1� � � - 5 � v � � —,S� flb��uC 0`. . � ClTY Oi �^,�IA �:fS,'� APPLI ON FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. p/E/�qM(IT NO //. �i � XECENLO 9Y DwTE RECErvEO D.�TE ISSVF �,.,..� 3_ iA Fcf� 3—i9_ COSTA MESA. CALIFORNIA APPROVED BV DATE CORRECTIONS SUBJ£CT T� 4iLDG. DEPT. REG. � PLAfv T_CH./ C ` � J � � ' R�P��--, I HEREBV AC�(NOWLEDGE T T I H4VE RE1D THI$ nPPLICATION 1ND STATE TM�T THE �BOVE IS C RRECT �ND tGREE TO COMPLY WITM �LL CITY ORDINwNCES AND 5 TE L�WS REGUL�TING BVILDING CONSTRUC� � T�� VALU ON SIGNATURE OF �� PERMIT FEE $ �O PERMITTEE S ``� PLAN CHECK S —� , wL —�J � AUTHORIZED AGENT K TOTAL FEE $ �-tJ vsM� �:. WEST lyfH STREET, y�'�� 4337 - 12-30-57 -:��=� CANCEL , 6s1u - 4-28-5a :.cio $soo. 60361 - 3-28-7z '!��. �� (�-`-i E 6ya gl � '�� ; , � _ ; , : � 1 � � 4 ; s (»a) �5a-52�3 • Faz (714) 754dB56 • www.ci.costa•mesa.ca.us 77 FAIR �Fi1VE, GOSIA MESA, GA 92ti26 ELECTRICAL PERMIT JobAdqress: 900 W 19TH ST Status: ISSUED Suite No Applied: 10/01/2007 Vi�inity: Issued: 10/01I2001 Parcel Nunmber: 42252422 Applicant: WIRTH, JOEL Address: / „ � � , ;/: � ' �, � ' � . � ; . Owner. . �BRANSON, JAY'K Aqdress .900 W 19TH ST �- . � COSTA MESA, CA � ; Contractor. ACME ELECTRIC Address: 780 NEWPORT CENTER DR #780 ISSUE FEE Temp seNice test Res. a/c package New Res (1-2 units) New Res (3+units) Pool I Spa Lighting Fixts Recept Outlet's Switches �� ' Non Res App1 Res Appl Service to 200a Service to 1000a Service over 1000a Morors to ihp Motors to 10hp Motors to SOhp Morors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pol� NEWPORT BEACH, CA Phone: 949-644-8801 Zip: / / Phone: Zip: 92627 Phone: (B49)644-8807 � Zip: 92660 License: 527459 ISSUED BY: ' , � � ,� � � �� , � , . �\ SCOPE OF PERMIT � � ERVICE UPGRADE TO 200 AMP�FOR EXISITING SINGLE FAMILY RESIDENCE.�NO RELOCATION OF, ,� SERVICE PROPOSED. - ' ' - -- � - ' - �uantity $23.50 80.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 530.50 50.00 50.00 50.00 50.00 $0.00 50.00 50.00 � ; so.00 S0.00 50.00 30.00 $0.00 50.00 0 0 0 0 0 , �0 0 0 y c. 0 0 0 0 0 0 0 - 0 0 ' 0 0 0 0 FEE SUMMARY Temp Dist System I Lighting Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw � � ................up to 10 kva/kw .................up to 50 kva/kw ............_...up to 100 kvalkw , ..................over 700 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand fireworks Stand Other EleIXrical Fee InvestigationFee, . - Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS �uantity 80.00 0 . $0.00 0 50.00 0 $0.00 0 , $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.OD 0 $0.00 0 50.00 0 50.00 0 50.00 0 50.00 50.00 50.00 $0.00 Ssa.Oo NOTICE: The work authodzed by ihis permit shall comply with all applicable handicap access requirements under California statutes and related �I regulations. (Ord. No. 9248, § 1. 12•21•92) EXPIRATION: This permit shall automaticaliy expire and become vold if work Is not commenced wlthin 180 days, or if work is suspentled or abandoned for a period oi 180 days. . INSPECTIONS: In order for the work authodzed under this permlt ro be consitlered legal, such work must compty with all epplica6le eodes, and all required inspeetlons end final epproval must be obtained. Failure to oblain inspections and final approvel will result in the expiratlon of this pertnit. FOR INSPECTIONS CALL: (714) 754-5828 rr... �..,.f•j211 WORKERS'COMPENSATON OECLARAnON: � I hare y eflirm under penalry of per�ury one oi Ue 1Wlowing declarations: ❑ I �ave end will malntein e certificata o1 consent to self-Insure for workers' compensatlon, as provided lar by section 3700 oi ihe LeDor Code, for the pertormence of Ne work ior whlch �his pertnit Is issueC. I have aM wW meNtain workers' oompenseibn Inwrarice. as requiretl Dy secUon 3700 of the Lebor Cade, for the pertormence of the xrork for whidi this permit is Lssued. My workers' compensation Insurance certiar and pdicy number are: Cerrier. PWity Number. (Thls sectlon need /rof De ownpleted // Ne pemJt 14 velued et ale hurMred tldlars (5700) w less.) ❑ I certity Uat In the peAortnflnce ai pwork for w�kh tltis pertnit is Lssued, I shell not empby eny person in eny manner so es lo becorne suEject to the workers' wmpensation laws of Callfomia B egree ihat tl I shoultl become sub�ect to the workers' compensatlon proNsiore o1 Section 3700 of t�e Lebor COCe, I ahall lonhwlih cwnply wlth Ihese p 1 0 J� Appllcant Slgneture: � Date: l o— I �(/ 1 WARNINO: FAILURE TO PE WORI(ERS' WIAPENSATIdJ OOVEMGE IS UMAWFUL ANO S/U11 SUBJECT AN EMPLOYER TO CRIMINAL PENALTES �fl0 CML FlNES UP TO ONE HUNDRED TIIIXISAND OOLLARE (E100,000), IN ADORION TO THE NST OF WIAPENSATIIXJ, OMMGES AS PRONDED FOR IN SECTION 31090F THE LABOR CODE, INfEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn that I em Iicensed under pr9Wslans of Chepter 9(commencing wlih Sedlon 7000) of DlNsion 3 0l Ihe Buslness end Profosslons CaAe, end my license Ls in lull force entl ettect Llc. a .. /, Class a . Camrectols Slgnamre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby eMirtn Ihet Ihere is a Constructlon lending egency tor the pertormance of Iho work tor which this pormit is Issued. (Sec. 3097, CiNI Code). Lentlefe Neme: Signeture: _ OWNER-BUILDER OECIARATIONS: Lendefs Address: Deta: I herehy eXlrtn that under penalry of per�ury Ihat 1 em EXEMPT FROM THE CONTHACTORS LICENSE LAW tor Ihe following reeson (Sec. 7031.5, Businass and Professlons Code: My ciry ar counry which requires e permit lo consiruct, alter, impmve, demWis�, or repeir any structure, pdor to its Issuenca, elw requires the eppliwnt for such pertnit b flle e signed stetement Uat he or she la Ucensed pursuant to the pmvisians at Ne Contrectore LJcense Lew (Chepier B(commendnp wIN SecUon 7000) ot DNLsion 3 ai ihe Business entl Professbns Code) or Net he or ahe is e:empt Iherefran and the besLs tor the ellepetl e:emptlon. My Ndatlon oi Section 7031.5 by any epplicam for e pem+t subjects Ihe epplicam to a dNl penalry oi not more than five hundred ddlars (5500J.): ❑ I, es owner of tha property, or my employees with weges es their sole wmpensatlon, WILL DO THE WORK, anC Ihe structure b not intentled or oHered for sele (Sec. 7044, BuSineSs end ProfeSslons Code: The Coniractors LJcense Law tloes not apply to en owner of properry who builds or improves thereon, flnd who does such work himselt or hersetl or t�roug� his or her own employees, provided Ihat such impmvemenis ere not Intended or oXered tar sale. tl, however, Ne building or improvement Is sdd within one yoar af comple6on, the owner-bWder will have ihe burdan of proving that �e or she did not build or improve br purpose ot sale.). ❑ I, es owner ot l�e D�oDerty, em E%CLUSIVELY CON7RAC71NG WI7H LICENSED CONTAACTORS ta construct the prqect (Sec. 7044, Business and Professions Cotle: The contrectors Llcensa Lew tloes not epply ta an owner ol proparty who builtls or Improves thereon, end who contracts for such project with a contractor(s) license pursuant to the Contraaors License Lews.). ❑ I am eaempt untler sec. Business and Professions Cade far �his reason: Signature: Date: Owner ID venfied by drivels Iicense. ❑ Yes ❑ No Drivers License Na. Veriticetlon o1 Ownership by (rype of document, i.e. - property tex bill or deed): DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFICATION: Expires: ❑ I hereby ceNfy ihat no excava0on fNe (5) or more teet in depth Into which e pereon Is requlretl lo descentl, wlll be made In Connection with work euthorized by ihls pertnit, end Ihet no builtling siructure, sceMolding, talsework, or demolition or dismentling Ihereof, wlll bo more then t�irty-six (38) fee� high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Celilomla Atlministretive Code). ❑ As owner-builder, I wlll not employ anyone to tlo work which would require e permit trom the Dlvislon ol Indusiriel Selery, es noteC ebove, unless such person �es e permlt to tlo such work irom the division. Signeture: Dete: Dlvision af Industrlel Safery Pertnit Number: CERi1FlCATE OF COMPLIANCE AND AIJfHORVATION OF ENTSiV: 1 cenify untler penelry ot perjury thet I heva reetl Ihls epDlication and stete that Ihe infortnalion given is wrrect. I egree to comply wlih ell stete laws and Gry ordlnances releting to Duiltling construction, entl euthodze representatives of the Ciry ot Costa Mese to enter upon the ebove-descnbed property for inspection purposes. I egree not to occupy or allow occupency at eny buildinp euthodzed by this permit until final inspeclion. COOE I. INSPECTION TYPF 1816 FixeO System Finel Fire Preventlan 1288 Pool Spa Flnal 200 Final Re-Root 201 Flnel BIocWRetaining Wall 202 203 204 Finel Fectory Fire Place Finel Slgn Flnal Demdltlan PAg It�EIS / �— /�/ Da V / cooe� msrecnoxTrve 208 Final MeC�enitel 208 Finel Plumbinp 210 Final Electdcel 212 Finel Flre PrevenNan 220 Flnal Plenninp Approval 222 Final Site 250 Finel Building/Occupency P!1IE 1[� �_. /' PRQIECT ROOflE55: C3 Q O W 1 9 TH S T UNIT: OWNEfl'SNAME: `��AP, PETER T aoDpEss: GRAP, GRACE M 2431 BOWDOIN PL COSTA MESA,CA 92626 AflCH/ENCINEEN: NEIL ��BRIAN NEG.NO.:CO^^ PDDPESS: 'D ANCHORAGE WAY ti��j�t PE"miTTEE: FREDERICK C. SHUMAKE CA 9000�14)645-4112 aoosess: 181 CECIL ST COSTA MESA CA 92627 LICENSE� CONTRRCTOB DECIANPTION: I here0y allirm I�al I am licensea un0er Omvisions ol C�aO�er 9(commencine wi1� Seclion 7000� ol Drvision 3 ot I�e Business an0 Protessions CoGe. an0 my license o in full brce anE eflect. cirr uc.: 0 � Z sraTe uc.: 5 8 6 6'7 S cuss: C-1 Da�e: Sipna�ure: L � WOHNENS' C M NSA ION OECIAflATION: I hereEy aHirm hat I �ave a[efli�nt ta sel .insure or a ceniliwte ol WOM1ers' Compensation Insurance. or a certi�ieE coDY ��eteol (Seclion 3800. La�. C�. voucrxo.: 1182504-93 E%P.ORTE: O3�OS�i�I cornvaxr: STATE FUND r] Cenilietl copy is hereby lumishetl. ,� Cerli�ie0 � wilh I�e ' y B`uiltlinA Oivisiort � ..ate'. APPIiCant: - E%EMPiIONFP MWOBNENS'COMPEN511TIONOECUMTIO . (TAissecUanneeGnothecomDleteOil permiisforonehmMreGg100�orkss�. I cetlily itlal in the oedormance of t�e work for w�ich t�is permit is issueQ I sllall not employ any person in any manner so as to 6ecome ' suGjecl to �he Warker5' Campensalion Laws of Califomia. oare: sipnature: NOTICE: It, afier making Ihis Oeclara�ion. you should DeCome su61ec1 �o t�e Worker5' Campensation pmvisions ol ihe LaDor CoGe. you must �ort�wil� comply vn�h suc� O�ovisions or I�is Dermit s�all be aeemeE revoked. CONSTBIlLTION LENUING RGENCY: I hereEy allirm ��at ihere is a constmction IenEing aAency tor t�e pedormance of the work for w�ic� I�is Oermil is i=_sue0 �Seclion 3097. Civ. C�. LENOEfl: ADUNESS: OWNEfl BUILUEfl OECLANATION: I hereby allirm I�a� I am exemp� �mm Ihe Conlraclors' State License Law for tne following reason (SecliOn 7031.5 Business and Pro�essional Code: Any ciry ol counry which requires a Dermit �a con5imct, alie�. impmve. Cemolish. or reDaii any simciure, prior to iis issuance. also repuires t�e applicani tor such permii to Iiie a signetl statement Ihai he/s�e is licens¢tl pursuanl to Ne pmvisions ol ihe Coniracmrs' S�ate License Law (Chapter 9(cammencing with Section 7000) of �ivision 3 of the Business an0 Pmlessions Coee) or Ihai he/she is exempl I�erelmm and I�e Dasis lor �he allegea erempiion. Any vialaiion o� Seciion 7031.5 Gy any applicanl for a permit subleCts �he aDPlicanl to a civil Oenally af na� more Ihan live �unGretl Eollars (E500). I, as owner ol Ihe pmpeny or my employees wiih wages as Iheir sole compensa�ion, will Oo ��e work, and �he ❑ s�mcture is not intentletl or ofiereG lor sale �Section 70aa. Business anG Pmteuional Cotle: T�e Comractars' S�ate license Law Uoes not ap01y to an owner ol a pmperiy w�o 6uiltl5 ar impmves �her¢on, and w�o Ooes such wafrc �imsel�/herself or �hmuAh his or �er own employees. O�aviaetl �hai such im0�avements are no�in�enEed ar oHereO br ule. if, howeve�l0e builtlinp or impmvement is sold wilhin one year Of completion, Ihe owner will have Ihe GurEen oi proving he/she tlid not huild ar impwve lOr Ihe Ourpose ol sale�. I, as owner of ihe pmperty. am exclusively conlracling with licensea conlraciors �a conslmci Ihe pro�ec� (Section 7044, Business ❑ antl Profes5ion5 Coae: ihe Conirac�ors' Sla�e License Law tloes not apply to an owner 01 pmpehy who builtls or impmve5 iherean C 5 C l I : ,.. CITY OF COSTA MESA —.BUILDING PERMIT PERMIT NO: E 064281 PLAN CHECK NO: N CONSTRUCTION TYPE: � PERMIT TYPE: ELE JOB DESCRIPTION :�CAANGE HURNED METER MAIN PEAM NO: E 064281 GOVT: N SUPP: N SQ FT: PURPOSE: OTH CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REPLACE HURNED ELECTRICAL METER MAIN ***�r*+�**+t**r*�r***�t****�r�t�r***x�****�***+r+rit�t**�r*x��**�r**�r�r+��r******�t*****+�*+�+�*r**+r*�; Z O N I N G R E Q U I R E M E N T S , S E T H 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• PAOV; PARCEL: 42252422 ZNE: REF NO: PLANNING NCSTES> ' i if fE 1f 9E j! 1E 1f i! f! if 1E M iE 1f ik if ik 1tlt iE j! 1f f! if !! ff 1f if 1f if it 1f�1f.iE'1� ff k 1E 1E iF 47f ff if 1f if iE if iF 1E iF i� iF 1E 1f 1E M 1k 1f 1F 1E ff ff if iF 1f if it fE if if !f if if IE if 1! iE iE D E V E L O P M E N T 'S"'E.�R V I C E S R E�`U I R E M E N T S ZONING APPROVED HY ��. DATE: BUILDING APPROVED BY : ' , , DATE: APPLICATION ISSUED HY: -0- k 1f !t k if iE M M iE 1t if if 1k it if i! iE iE iE f! iE ik7F;��3F 1t 1k k!f �t iE iE iE 1f it if if it iE iE it 1E 1E 1f M 1E M if i! ik if iE ff !! i! 1f 1E i! 1t LEGALIZATION:N F E E �� S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 18.50 5�z PLAN ISSUE FEE 15.00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 18,50 15.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBZNG ELECTRIC MECHANIC 33,50 STRUCTUAAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL PAID DUE 33.50 33,50 .00 33.50 OVER/SIIORT: ,00 FIRE 5MIP/TOT GRADING PLAN—CHECK antlwhocontraclstorSuc�D�oiec�swilhawnvacmr(s�licensepursuamlothe nnVactors Iate icense aw�. amaware ,�****,�,�*********,�******,*****,��**,�***�***************************************** Ihat Omol ol their Worker's Campensaiion insurance should be pwvitletl Io me. � I am exempi untler Section: B. 8 P. C. I N D 2 V I D U A L F E E B R E A K D O W N io�inisreason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Daie: Ownec i Eo �ere�y cemly ihat I am aware al antl untlerstan0 t�e reQuiremems ol Caliiomia Healih anA Salery CoOe Sections 2550.5, 25533, an0 ELE 1 S ER V I C ES B ELOW 6 0 0 V 6 B ELOW 2 O 1 AMP 1 8. S 0 1 b, 5 0 2553a ane ��a� I or any Iuiure Ouilaing acu0am wilVwill nm (tlrcle one) need to compty vn�� saiG state coaes ana the repuirements for a END OF FE ES permit lor conslmction or motldica�ion imm lhe An Oualily Managemenl Disiritl. Re5i0enlial cons�mc�ion applicaiions are exem0� �mm IIICS¢ p�ON510f15. Oale: ApPlicani: I hereby [etlily Ihal I have read Ihis apObcalion anU 51aie �ha� Ihe a�ove information is correcl I aAree lo comply wilh all city and counly ortlinances antl s�atelawsr¢latinglo butlding constmction and hereby authorizerepre5eniatives oi�his ciryio enteruponthe ahove�men�ioned pmperty for in50eciion hrp`5. ��(/��` A U Oa�e�. Signamre: 7_ �u�_ Drivets License oi Social $earity x: t64L46 Wlii�e—Butlamg: Green—Cotlo Enbrcement; Canary—AOOlicam: Pink—Ravenua; Goltlenrod—Asseswr D1 00148153—OD143153 Ti1 T 33.50 DATE� i0/04/93 TIME: 14:57 :, ._�.. .... CONSTRUCTION AND PLANNING POOL pA APPROVALS Permit�k Date Inspector qPPROVALS Permit# Date Inspector ' 1.•7emporary Eiectrical ServieB or Pole 52. Pool & Equipment Location Z. Soi! Pipe•Undrgrnd. . 53. Steei Reinforcement :f. �lectricaf CondGit Utility•Undrgrnd. ` 54. Forms 4. Electrical Cond�it-Undrgrnd. . 55. Electrical Bonding 5, 5teef. Reinfo�cemenc '� .56. Rough Plumbing & Pressure Test : 6. �Eleclrical�U�ER Grnd. . 57. APPROVAI TO COVER-GUNITE , '7. �ootings ' 58. Electrical Conduit•Undrgrnd. I $. �oundation . 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe•Gndrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK It1. P*operiy Sewer Line & House Conaect(on 62. Backwash & Receptor-final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Orains 64. Plumbing System � Final 14, pough Plumbin9 � 65. ciectrical•Final 75. Rough Electrical•Condult 66. So�ar System-Final 76. Rough Electric Wiring 67. Fencin� & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTEPING I 18, pough Electricai-T Bar Ceilinq 69. POOUSPA SYSTEMS PINAL � 79. Rough Hea2i�g & Air Conditioning FtRE DEPT. REQUIREMENT 20. �Fough E3ctory Fireplace - APPROVALS Permit # 21. Ducts, in Struciure . .� � � 70. t�nderground'Hydro ,� 22. ducts, Ventilatin9 � 71. Product Piping G�'Gas ❑Oil 23.GasPipe�Rough&'Yest . � 72. Undergroundflush 24. .floof Framing• �� `� 73. Undergrnd. SlorageTank � Gas ❑ Oil 25. Roof Sheathing ' , . - � 74, Overhead Hydro � � . 26. T-Bar Ceiling (Structural) & Monocoat . � 75. Dry Chemical . � '� 27. Fromeand Flashin9� .�� ; 76. Dry Standpipe = � �' .;ri, I 28. Lathing $i Sid�ng � � . . 77.� "F�XED SYSTEM FINAL ' �29. Insulation '� � � . 78. FIRE PREV. FINAL - .30. Orywail Nailin9 � � ;- � HEALTHflEPT. REQUIREMENT •.�1, plaster Brown Coat; , ' _ 79. FINAL Iht$PECTI6N , � �32.,Electrical•Power Me.er-Final � �G�� '80. FOOD CERTIFIC�TE ISSUED 33.:Final Electric _ � - �0�� Notes: . .. - . _� � �'34. Final Heating& Air Co�ditioning , , . , _. 35. �Fina1 Gas.Pi�B-Test ' - . - ' � • � 36. Hood or Canopy � . � � . • 37. Final Factory Firep(ace � � � � ' ' . . 38. Final Plumbing , , �� , � . 39. Water Service•Finat• � . ' .. 40. Gas Service-Final . �, ' � � � . 41. Solar pomestioFinal � � � � • � �i 42.-8ackfiow Preventer. , . � ' 43. Backflow Irrtgation � - � 44. L.andscape irrigation System ; - . , . • , _ 45. Sound A[tenuation " � . " -� ,'�.� � 46. Handicap Regulations � � , '� - �� , - �� 47. EINAI STRUCTURE & BULLDING - � " . i. . 48. FINALPLANNING; '. ' � �49. Electric Release to Edison , , .. � 50. Gas Release tb Southern Califor�ia Gas Cn : ,51. CERTIFICATE OF OCCUPANCY . • � • No Date . � ___. w � CITY OF COSTA MESA pMFs BlIILDING DIVISION '`�� 77 FAIR DRIVE. COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us f ° ` FOR INSPECTIONS CALL: (714) 754-5626 �'"°'°'�� PERMIT NUMBER: P10-00087 PERMIT TYPE PLUM APN: 42252422 JOB ADDRESS: 900 W 19TH ST CM Vicinity: STATUS: ISSUED DATE ISSUED: 0612312010 ISSUED BY: RMD Suite/Unit: SCOPE OF WORK: PLUMBING PERMIT Tb EXTEND GAS LINE FOR A FIRE PIT COCATED AT REAR YARD. OWNER: SIMPSON MICHELLE PHONE: 949-645-4578 APPLICANT: SIMPSON MICHELLE PHONE: 949-645-4578 � CONTRACTOR: OWNER-BUILDER Address: Ciry/State: � - ARCHITECT: ENGINEER: ZipCode: Address: City/State/Zip: Address: Ciry/State/zZip: License No. License No. 900 W 19TH ST COSTA MESA, CA 900 W 19TH ST : COSTA MESA, CA License No. 000000 PHONE: CELL: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: PERMIT FEE: TOTAL FEES: $0.00 $39.45 $39.45 PHONE: PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In ortler for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. COOE/. INSPECTIONTYGE O�T INIIML CODE/ INSPEL➢ONTYPE DR INTI71AL5 7676 Fixed System Final Fire Prevention ZO6 Final Mechanic2l 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electncal 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Pianning Approval 203 Final Sign 222 Final Site �/ 204 Final Demolition 250 Final Building/Occupancy /� � � �5 � ��"' - - � WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of ihe tollowing declarations: ❑ I have and will maintain a Certifica[e o( ton5ent ro 5elf-InSure (Or workers' compensation, as provided for by section 3700 of the labor Code, (or Ihe peRormance of the work (or which this pertnil is issued. ❑ I have and will maintain workers' compensation insurance, as required by sectbn 3700 of the Labor Code, for the peAortnance of the vrork fw wfiich this permit is issuetl. My workers' compensation Insurance carrier and policy number are: Carner. (in¢ secfbn neetl nof Oe mmpeledd tne ce�4ls vah+eE al wre huntlretl Mlars (5100) w less.) Policy Number: _ C❑�I•certify that in the pedormance of Ihe work for which this permit is issued, I shall nol ploy any person in any manner so as to become subject lo lhe workers' ompensation laws of Califomia, and agree that if I shoultl becom�bje t to the workers' compensalion provisions ot Section 3700 of the Lab C , I sha (oithwith comply wilh Ihese provisions. I ' Signat � t : WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed untler provisions of Chapter 9(commencing wilh Section 7000) of Division 3 of the Business antl Pro(essions Code, and my license is in (ull torce and eRect. Lic. # Class # Contranor s Signawre CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm [hat there is a consWctbn lending agency for the pertortnance of the v.ork fa wtiich tNs pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Adtlress: SignaWre OWNER-BUILDER DECLARATIONS: I hereby aNrm t�at under penalty o( perjury that I am EXEMPT FROM THE ' CONTRACTORS LICENSE LAW for thB following reason (SeC. 7031.5, Business and Professions Code: Any city or county which requires a permit to conswct, alter, impmve, demolish, or repair any structure, prior ro its issuance, also requires the applicant for such pertni� to fle a 5igned 5tatemenl that he or She is licensed pursuant to lhe provisions of Ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt thare(rom antl the basis for the allegetl exemption. Any violation of Section 7031.5 by any applicant for a permit subjecls the applicant to a civil penalry of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and Ihe struclure is not intentled or oRered for sale (Sec. 7044, Business antl Professions Code: The Contractors License Law does not apply to an ovmer ot property who builds or improves Ihereon, and who does such work himself or herself or throug� his or her own employees, provided Ihat such improvements are not intentled or oflered for sale. If, however, Ihe building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). �D,Y 1'as ovmer of ihe property, am El(CLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to consWct the project (Sec. 7044, Business and Professbns Code: The cont2ctars License Law dces not appty to an owner of pmperty wfio builds or improves thereon, antl who conlracts (w such project with a contracta(s) license pursuant to the Contraclars License Laws.). ❑ I am exempt under sec. Business and Prof ssions Code for this reason: � 2�, ID re�' — ' G'�x-• 905)-06 (3/O)) ✓ .� Owner ID verifietl by driver�se. Yes ❑ No � Driver's License No. �� CEzpires: �� VePificztion ot Ownership by (t pe of tlocuT me t, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: � I hereby certAy that no excavation frve (5) or more feet in depth into which a person is required to descend. vnll 6e made in wnnec[ion with work authorized by this permil, and that no building stmcture, scaffdding, falsework, or demolition or dismanUing thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, SeG. 341, Trtle 8, Califomia Atlmini5t2tiv8 Cotle�. ❑ As ovmer-builder, I will not employ anyone ro do work which woultl require a permit from the Division o( Indusirial Safety, as no�eC above, unless such person has a permit to do such work from Ihe tlivision. AppiicanYs Signawre Da�e Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will �he applicant or present or fWure buildinq occupant need to file and certify a Business Plan for emergency response b release or threa[ened release of a hazardous material? ❑ Yes ❑ No (Seclion 25505 of Ihe California Health antl Safery Code requires, wilh some exceptions, lhat a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time dunng a reported year a quantiry of hazardous materials equal to or greater t�an a weight of 500 pountls, or a volume of 55 gallons, or 200 cubic feet o! compressed gas at standard temperaWre and pressure�. 2. Does or vrill the applicant or present or future building cecupant need to file a regislration fortn for acutely hazardous matenals? ❑ Yes ❑ No (Section 25533 of the Califomia Heal[h and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which a[ any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weigM of 500 pounds, or a volume of 55 gallons, or 200 cubic Feet of compressed gas at slantlartl temperature and pressure). 3. Does or will the applicant or present or future building occupaN need to prepare an RMPP (Risk Management and Prevenlion Program for acutety hazardous materials�? ❑ Yes ❑ No (Section 25534 of Ihe California Health and Safery Code provides Ihat [he Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required [o register acutely hazardous materials wilh �he Fire Depatlmen[. 4. If an RMPP is presently required, has Section 25534 of lhe Califomia Health and SaFety Code been fully complied with7 ❑ Ves ❑ No 5. Does or will Ihe applicant or present or lu[ure building Octupant require for lhe work which is the subject of this application a permit (or such construction or motlificalion from the SoWh Coasl Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the Calitomia Govemment Code requires Ihat the requested infortnation be fumished on applications fa non-resitlential building pertnits). 6. Will any part of the facility to be consWcted under this pertnit be within 1000 tee[ from the outer boundanes of a school? ❑ Ves ❑ No Qf "yes", the (acility must meet the requirement of Sections 25534 and 42303 o! the California Heallh antl Safety Code). 7. If a permil from the South Coasl Air Quality Management DisMct or other air pollution control disMct or agency is required for Ihe v.ork which is lhe subject of this application, have all of the disclosures prescribed by Calitomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If'yes", attach certi(cate of compliance from the appropriate air pollution control oKceq. CERTIFICATE OF COMPLIANCE: I certify Ihat under penally of perjury Ihe information given above is corcecl. I agree to comply with all slate laws and city ordinances regarding Hazartlous Materials and Emissions. SignaWre Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application antl state t�at the information given is correcL I agree to comply with all state laws and city ordinances relating to building construc[ion, antl aulhonze representalives of ihe City of Costa Mesa to enter upon Ihe above-descnbed property for inspectio p�ses. I agree not to occupy or allow occupancy of any building aut riz tt is permit until final inspection. � a of legal Ov.ner(s) � e — -.T�S`..�-.3''.:.r.,.. AnG/or Aul�onze4 AOplicant Ddt¢ ��—_..: � r �-,. ..""""_" """_"'"` i ' CITY OF COSTA MESA , o�`°"'F9 BUILDING DIVISION • + F � 77 PAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Faz (774) 754-4856 • www.ci.cosla-mesa.ca.us . —, �. FOR INSPECTIONS CALL: (714) 754-5626 "�� fi PERMIT NUMBER: BX11-00077 PERMIT TYPE B MISC STATUS: ISSUED APN: 42252422 DATE ISSUED: 04/21/2011 Zoning: , ISSUED BY: CAC JOB ADDRESS: 900 W 19TH ST CM Suite/Unit: Vicinity: REAR OF PROPERTY Primary Occ: 32 Const Type :?? SQ. FT: 229 Valuation: $9,000.00 SCOPE OF WORK: . - - CONSTRUCTION OF A 229 SF FREESTANDlNG LATTICE PATIO COVER LOCATED AT RE.4R OF YARD. OWNER: SIMPSON MICHELLE Address:: 900 W 19TH ST Ciry/State: COSTA MESA, CA Zip Code: 92627 Phone: 949-645�578 � APPLICANT: SIMPSON MICHELLE Ciry/State: COSTA MESA, CA Phone: 949-280-2670 CONTRACTOR: Address: Ciry/Stale: Zip Cade: ARCHITECT: Phone ENGINEER: Kf21STOF NADASI PE Phone 774-630-6100x114 ' FEE SUMMARY Building Plan Check: , Building Permit: Electrical Permit SMIP Residential SMIP Commercial Bldg Std Admin Fund Monday thru Friday - 7:00 am thru 7:00 pm. Address: 900 W 19TH ST Zip Code: 92627 License No. Phone License No. License No. 64525 $108.71 $167.25 $0.00 $o.so $0.00 $1.00 -9:00 am thru 6:00 pm. Unit .. ., I Unit: �! Unit: Cell: Un,t Sundays antl the following Federal Holidays: u NOTICE: The vrork authorized by this pertnit shall Comply with all applicable handicap access requirements under California statutes and relatetl �regulations. (Ord. No. 92-28, § 1. 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval musl be obtained. Pailure to obtain inspections and final approval will result in lhe expiration of this pertnit. COOEt. INSPEG110HiVPE ORTE IN111UL5 COOEt INSPECTIONME DA7E , INRIIAI 1618 Fived Sysiem Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing - 200 Final Re-Roof 270 Final Electrical "� � 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory FirH Place 220 Final Planning Approval -��----�----- '203 Final Sign 222 Final Site �- .-.-�+ u�� . y� � 204 Final Demolition 250 Final Builtling/Occupancy ��i —l�_� �__� WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalty of perjury one of the tollovring declarations: ❑ I have and will maintain a certificate of wnsent lo self-Insure for workers' compensalion, as providea tor by section 3700 of the Labor Code, for the peAormance o( the vrork for which Ihis permit is issuetl. ❑ I have and will maintain workers' cwnpensation insurance, as requiretl by seclbn 3700 of the Labor Code, tw the pedortnance of the v.ork tor v,fiich Ihis pertnit is issued. My workers' compensation Insurance cartier anC policy number are: Cartier. (inis SetYion nee0 nol De mmpletM Itbe pem�C a vaAxtlat one nurqrM OJWrslS IPOI akSt.) Policy Number: ❑ I certi(y lhat in lhe peAormance ol the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to tha workers' compensation laws of Califomia, and agree that if I should become subject to the vrorkers' compensalion provisions of Seclion 3700 of the Labor Code, I shall forthwith wmply vrith lhese provisions. Appionfs Signatare Da�e WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUT AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CO�E, INTEREST, AND A7TORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that t am licensed untler provisions of Chapter 9(wmmencing with Section 7000) of Division 3 of t�e Business and Prolessions Code, and my license is in full force and effect. Lic. # qass # Comracmr's Sgnamre Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affvm that lhere is a constmclan lending agency for the peAortnance of the v.ork fa v.hich this pertnit is issued. (Sec. 3097. Civil Cqde). Lender's Name: Lentler's Adtlress: SignaWre Da�e OW NER•BUILDER DECLARATIONS: I hereby aKrm that under penalty ol perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE lAW for ihe following reason (Sec. 7031.5, Businass and Professions Cotle: Any city or county which requires a permit ro constmct, alrer, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such pertnit lo file a signe0 statement thal he or she is licensed pursuant to the provisions o1 lhe Contractors License Law (Chapter 9(wmmencing wilh Seclion 7000) of Division 3 of the Business and Professions Code) or that he or she is ezempl Ihere(rom antl the basis for the alleged enemption. Any violalion of Section 7031.5 by any applicant for a permit suDjects ihe applicant to a civil penalty of not more than MeJ�undred dollars ($500).): i �� I, as owner of tha property, or my employees with waqes as their sole �cBmpansalion, WILL DO THE WORK, and the strucWre is not intentled or offered for sale (Sec. 7044. Business and Professions Code: The Conlractors License Law tloes not apply to an ovmer of property who builds or improves Ihereon, and who does such v.vrk himself or hersel( or through his or her ovm employees, provided that such improvements are not intended or oflereC for sale. If, however, the 6uilding or improvement is sold within one year of completion, lhe ovmer-builder will have Ihe burden of proving that he or she did not build or improve for purpose ol sale.�. ❑ I, as ovmer of lhe property, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construcl the project (Sec. 7044. Business antl Pro(essbns Code: The contractors License Law dces not apply to an owner of property who builds or improves the2on, antl who cont2cts for such project with a contracta(s) license pursoam to the Contractors License Laws.). ❑ I am exemp[ under sec. Business antl Professions Cotle for this reason: 7 .�.�SrgnzWra'� � Date 3059�d6 � /0]) � Owner ID verified'by drio... ❑ No � 1' J Om��s�.Cicense No. Expires: /� � Y Verifcation of Ownership by (type o( document, i.e. - properly tax bill or tleetl): DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certily that no excavation frve (5) a more feet m depth into which a person is required to descend, will be made in connection with vrork author¢ed by this pertnit, antl that no building struclure, scaffdAing, false�wrk, a demolition or dismantling ihereof, vrill be more than thirty-six (36) feet high. (Chap. 32, Grp 2, M 2, Sec. 341, Title B, Califomia Administ2tive Code). ❑ As owner-builtler, I will nol employ anyone to tlo vrork which wrould require a permit Irom Ihe Division of Industrial Sa(ety, as notetl above, unles5 such person has a permit to tlo such work Irom the tlivision. AD�licanl'S Signature Dale Division of Intlustnal Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future builtling xcupant need to file and ceAify a Business Plan for emergency response to release or threatenetl release o( a hazardous matenal? ❑ Yes ❑ No (Section 25505 of the Cali(omia Health antl Safery Code requires, with some : exceptions, that a Business Plan be fled with the Costa Mesa Fire 1 Department by every business which has at any one time dunng a reported year a quantily of hazardous matenals equal to Or greater lhan a weighl ol � 500 pountls, or a volume of 55 gallons, or 200 cubic feet of wmpressed gas � at standard IemperaNre and pressure). r 2. Does or will the applicant or present or fulure building occupant need to file a registration form for acutely hazardous matenals? ❑ Yes � No (Section 25533 of Ihe Califomia Health antl Safety Code, wilh sone exceptions, requires registralion with the Cqsta Mesa Fire Department by each business which al any one time has on hand a quantiry of acutely hazardous malenals equal ro or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic teet of wmpressed gas at standard temperature and pressure�. 3. Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous malerials)? ❑ Yes ❑ No (Seclion 25534 of the California Heallh and Safety Cotle pmvitles Ihat the Costa Mesa Fire Department may require the prepa2tion, certification and filing with the Fire Department of an RMPP by businesses which are required to regisler acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Seclion 25534 of Ne Califomia Health antl Safety Code been fully complied with7 ❑ Yes ❑ No 5. DOes Or will the appliCant or Dresenl or Wtura builtling occupam require /or me work which is Ihe subject of this application a peimit for such construction or moCification from !he South Coast Air Qualiry Managemen[ District or from any other air pollulion control district or agency7 ❑ Yes � No (Section 65850.2 0( Ihe Califomia Govemment Code requires tnat the requestetl intwmation be Iumishe0 on applications fv ron-residenUal building permits). 6. Will any part of the facility to be constructed untler Ihis permit be within 7000 feet from the outer boundanes of a school? ❑ Ves ❑ No (If yes . the laciliry must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7. If a permil Irom Ihe South Coast Air Ouality Management DisMcl or other air pollution control districl or agency is requiretl lor the vrork whic� is the subject of this application, have all of the aisclosures prescribed by Califomia Health anA Salery Code Section 42303 been made7 ❑ Yes ❑ No 8. (If'j�es", attach certifcate ot compliance from the appropnate air pollution control oKcer). CER7IFICATE OF COMPLIANCE: I certify that untler penalry of peryury the infortnation qiven aDove is correct. I agree to wmply with all state laws and city ordinances regarding Hazardous Materials and Emissions. 9gnaWre Daie CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 certify under penalry of perjury that I have read ihis appliwtion and state t�al the in(ormation given is correcl. I agree to comply with all state laws and ciry ortlinances relati bn" dmq constmclion, and authorize representatives of the Ciry of C la Mesa�to enter upon the above-0escribed property for insp on pu oses. I ag2e not to occupy or allow occupancy of any buildinq au onzed t' i4until final inspection. �/ . 1 "1 7i� � i ' I Owner(s) - —'— "Dale' .�+ An0/or Aulhorizetl Applit�anl