HomeMy WebLinkAbout2530 CORNERSTONE LN - Building Permits(714) 754-5273 • Fex (774) 754-4856 • www.c�.costa-mesa.�.�LDING PERMIT �� FAIfl DRIVE, GOSTA MESA, GA 92626
JobAddress: 2530 CORNERSTONE LN
Suile:
Viciniry: CORNERSTONE .
Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N
Parcel Number: TPN30053 Zoning:
App�icant: GOODWYN, JIM
Address: 16845 VON KARMAN
IRVINE, CA
Phone: 949-7563310
Zip: . 92606
Owner: RICHMOND AMERICAN HOMES OF CAtIFORNIA
Address
Phone:� 949•756-7373
2ip:
Contractor: RICHMOND AMERICAN HOMES OF CALIFORNIA INC
Address: 16845 VON KARMAN �� �
Phone: 949-756-7373
Status: ISSUED
Applied: 06/12/2006
Issued: 06/13/2006
ISSUED BY:
IRVINE, CA - . , � . � �
Zip: 92606 License: 487535 '
nrch : KENNETH NIEMERSKI Eng: GARY A MCCLANAHAN
Address: 2031 ORCHARD DR " Address: OPTION ONE CONSULTING ENGINEERS
SUITE 100 Phone: 949-553-9100 - NEWPORT BEACH, CA -Phone: 949-553-7916
NEWPORT BEACH CA - 20311 ACACIA SUITE 240
Zip: 92660 License: 23971 _ 92660 � License: C042553
SCOPE OF PERMIT
PHASE 1 CORNERSTONE HOMES
PLAN 2AR
CONSTRUCT NEW 1947SF 2-STORY SFD WITH ATTACHED 461SF ATTACHED GARAGE. 24SF ENTRY PORCH. REF: BO6-00341
Plan Check: $1,006.30
Permit: $1,548.15
SMIP Res: $19.83
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $2,574.28
SETBACKS
MAIN STRUCTURE Front 200. 0
ACCESSORY
PARKING
Front 0- 0
Existina: 0
FEE SUMMARY
PLANNING & ZONING
Rear 75-0 Lefl 10-0 ..�
Rear 0-0 � Left. 0-0
Reauired: 148 Pr000sed: 148
Calc Valuation:
Claim Valuation:
Right . 45- 0,
Right 0-0
,$198,306.48
$0.00
NOTICE: The work authodzed by thls permit shall comply with all applicable handicap access requirements under Celifoinia statutes and related
ragulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become voitl II vrork Is not commenced within 180 days, or i(,�rk is suspended or abandoned
for e period of 180 deys. �l
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inapeetlona end final epproval must be obtained. Failure to obtain inspections and tinal approval will result in the ezpiretion of this permit.
FOR INSPECTIONS CALL: (714) 754-5628
24a&68 (8/00)
WORKERS' COMPENSATION DECLARATION: � '
I hereby eflirtn under penalry ol periury one of the following daclaretions: �
❑ I heve end will maintain e certificate of consent to seH-Insure tor workers' compensetion, es pmvitle0 tor by section 3700 0l the Lebor Code, for Ihe pertortnance of ihe
work for which t�is permit is issued. '
need nof be
n Insurence, as requiretl by section 3700 0l the labor Code, for the perfortnance of the work for which this permit is issuetl.
endpolicynumberare: ! �-,=r��� ��
kS W/d^7 C! Pollty.Num6er.—
� veluetl et one hundred dallars ($100) or /e'SS.J ��` "
❑ I certity Ihat in Ihe peAormance of the work for which this pertnit is issued, I shall not employ eny person in eny manner so as to becoma subjec� to the workers'
wmpensetlon laws oi Califomia, antl egr e thet II I should become subject to the workers' compensation provisions of Sactlon 3700 of Ihe Labor Cade, I shall forthwith
comply with thes�p visidns. I
ApplicenfSlgnet_ure: i , Dete: ^ � �� �/[7l�
WAPNINO."FAILURE TO SEC R WORKERS' COMP TION ERAGE IS UNL4WFUL AND SHALL SUBJECT M! EMMOYER TO GRIMINqL PENAL ES M1D pVIL FlNES UP TOONE HUNDRED
TKKISANDWLLAFE(5100, ADDITIONTOTHECOSTOFCOMPENSATIIXJ,OAMAGESASPROVIOEDWRINSEGTION�O60FTHELABORCODE,IMEREST,ANDATTORNEI"SFEES.
LICENSED CONTRACTORS DECLARATION:
Chapter 9(commencing with Section 7000) of Division 3 of the Busin�.}s and Professions Coda, end my license is in full
CONSTRUCTION LENOING AaENCY:
❑ I hereby eHirtn that there is a construction lending agency for Ihe pedormance oi t�e work tor which t�is permit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lenders Atltlress:
Signatura:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aNirm Ihe� under penalry ot perjury Ihet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Busineu end Protessions
Code: Any ciry or counry which requires a permit to consiruct, alter, improve, demolish, or repair any sWcture, prior to its issuanca, also requires Iha epplicant for such pertnit
b flle e signed stetement that he or she Is Ilcensed pursuent to the pmvisions ot the Contractors Licensa Lew (Chapter 9(commencing with SecOon 7000) of Dlvision 3 oi ihe
Business antl Protesslons Code) or that he or she Is ezempt Ihereirom and the besis for ihe elleged ezemption. Any vlolation of Section 7031.5 hy eny epplicant for a permit
sub�ecis t�e epplicant to a civil penalry of rwt more then five hundred dollars ($500).):
❑ I, as owner ol the property, or my employees wllh wages as their sole compensation, WILL DO T1E WORK, antl the structure is not intended or oNered for sale (Sec.
7040, Business end Professions Code: The Contrectors License Law does not apply to en owner of propeny who builds or improves ihareon, antl who does such work
himseli or herself or through his or her own employees, provitletl ihai such improvemeNs ere not intended or oNeretl tor sale. If, however, the 6ulltling or impmvement is
soltl within one year of completion, ihe owner-builder will have the burden ot proving that �e or s�e did not build or improve for purpose ol sale.).
❑ I, as owner ol lhe properry, em EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 70a4, Business entl Professions
Catle: The contractors Ucense Law Ooes not epply to an owner oi property who bullds or Impmves thereon, entl who conirects tor such project wlth e contractor(s)
license Dursuant to the Comraciors License Laws.).
❑ I am eaempt under sec. Business and Professions Code for Ihis reason:
Signature: Date:
Owner ID ventied by dnvers license. ❑ Ves ❑ No Drivels License No.
Verification of Ownership by (type ot document, i.e. � proparty taz bill or tleetl):
DIVISION OF INOUSTRIAL SAFETY PERMIT CERTIFICATION:
Expires:
❑ I hereby certity ihat no ezcevation five (5) or more teet in tlepth into which e person Is required to descend, will be made in connection with work euthonzetl by ihis
permit, and ihat no builtling sWdure, scaHolding, talsework, or demolition or dismantling ihereoi, will be more than thirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title e, Celilomia Administretive Code).
❑ As owner-Oulltler, I will not employ enyone to do work which would require e permit tram the Division of Industnal Sefery, as noted ebove, unless such person has e
permit to do such work from the tlivision.
Signature: Date:
Division of Industrial Salery Permit Number:
CERTIFlCATE OP COMPLIANCE AND AUTHORIZA710N OF EMRV: I certify untler penalry of perjury that I have read ihis epplication anC state that �he information given is
correct. I agree to comply with ell state laws antl ciry ortlinances relating to builtling consiruction, end authorize representatives of t�e City ot Coste Mesa to enter upon the
ebove-described properry for inspection purpases. I agree not to occupy or allow occupancy ol eny building authonzed by �his pertnii until finel inspection.
COOE �. INSPECTIONTYPE
1616 Fixetl Systam Final Fire i
1266 Pool Spa Final
200 Final Re-Rool
201 Final Block/Fletaining Well
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolitian
Irnrtia�s
COUE� INSPECTIONTYPE
206 Finel Mechanical
20B Final Plumbing
210 Flnel Elecirical
272 Final Fire Prevention
220 Final Planninq Approval
222 Finel Site
250 Final Building/Occupanry
Date
Q�, INTIfIFLS
(714) 754-5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DflIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suile No
Vicinity:
Parcel Nunmber:
2530 CORNERSTONE LN
TPN30053
App�icanc GOODWYN, JIM
Address: 168q5 VON KARMAN
STE 100
IRVINE, CA
Phone: 949-756-7373
Zip 92606
Owner: RICHMOND AMERICAN HOMES OF CALIFORNIA
Address
Phone: 949-756-7373
Zip:
Contrador: RICHMOND AMERICAN HOMES OF CALIFORNIA INC
Address: 5171 CALIFORNIAAV
SUITE 120 � Phone: 949�67-2600
IRVINE, CA Zip: 92617
License:487535
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixls
Recept Outlets
Swiiches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over t000a
Motors to thp
Molors to tOhp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Status: I SS U ED
Applied: O6/13Y2006
Issued: 06/132006
ISSUED BY:
SCOPE OF PERMIT.
PHqSE1CORNERSTONEHOMES � -
PLqN 2AR
CONSTRUCT NEW 1947SF 2-STORY SFD WITH ATTACHED 461SF ATTACHED GARAGE. 24SF ENTRY
PORCH.
REF:BO6-00914
WORK TO INCLUDE: 3 LIGHT FIXTS, 4 RECEPT OUTLETS, 1�SWITCH, 1 MOTOR TO t HP
$23.50
50.00
$0.00
$109.03
50.00
$0.00
$3.30
$4.40
si.�o
$0.00
50.00
$0.00
$0.00
$0.00
$4.75
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
1947
0
0
3
4
i
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
FEE SUMMARY
- Temp Dist System / Lighling
Busway/100ft
Standing Sedion
Misc Eledrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
- - ...............up to 50 kva/kw
- ' .................up l0 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
low Volt Wiring SystemJ Ckt
.Misa Conduit
Misc. Conductor
� Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Firevrorks Stand , �
Other Eledrical Fee
Investigation Fee
Plan Check Fee
Reinspeclion Fee
duantity
$0.00 0
$0.00 0
50.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
so.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
90.00 0 ,
50.00 . 0 '
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E146.08
NOTiCE: The work authori;ed by ihis pertnit shall compty with all applicable handlcep aaess requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-g2)
EXPIRATION: This permit s�all eutomatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
lor a perfod of 180 days. /
INSPECTIONS: In order for the work euthorized under this pertnit to be considered legal, such work must compty with all applicable codes, and all
requlretl Inapectiona end flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expifation of this permit.
FOR INSPECTIONS CALL: (774) 754-5626 d
zme-oe ls�ool
WORKERS'COMPENSAnONOECLARAnON: �
I hereby eHirm under penelty of perjury one oi t�e following declarations: �
❑ I heve end wlll malntein e certllicete ol consenl to seli�lnsure for workors' compensation, es provitled for hy section 3700 of ihe Labor Code, for ihe paAormance of the
work for whlch ihis permit Is issued.
❑ I have antl wlll malntain workers' compensatlon insurance, es raquirea by section 3700 of Ue Lebor Cotle, For Ne peAormance of the work lor which Nis pertnit Is issued.
My work%� compansation Insure e certier an pollcy number are:
Carrier. i Iw�G r�(�.... �e ��QSj1l.�P Policy Number. �a—i0�"f �
(This section neetl nof be canplefed i! fhe permit is'valLede! one hundred dollars ($100) or less.) .
❑ I certily thel in Ihe peAormenco ol ihe work lor which Ihis pertnit is issuetl, I shall not employ eny person in any manner so as to become sublect to the workere'
wmpensatlon lews ol Calitomia, end egre thet il I shoultl become suD�ecl lo the workers' compenution provisions ot Section 3700 0l Ihe Lebor Cotle, I shell forthwith
comply with �ha5e provisi ns. ,
ApplicemSignaNre: Date: ,�/�f9
WARNING: FAI�UFE TO SECURE O KERS' COMPE O CO ERAGE IS UMAWFUL AND SHALL SU6JECi PN EMPLOYER TO CRI� P�TIES AND GVIL FlNES UP TO ONE HUNDRED
hKK1SAND OOLLARE (5100,000�. I �ITION TO THE COST O �MPENSATION, DAMAGES AS PRONDED FOR IN SECTION 3IO60F THE IABOR CODE, INiEREST, AND AiTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy attirtn that I em licensad un r p Nsio of Chepter 9(commencing with Section 7000) ot Division 3 of ihe Busine ntl Professions Coda, and my license is in full
lorce end eflect. Llc. a Class x �
Cantwctofs Signature: � Date:
CONSTRUCTION LENDING AG V:
❑ I hereby aXirtn ihat there is a consiruction lentling agency for the pedormence ot the work tor which t�is pertnit is issuetl. (Sec. 3097, Civil Cotle).
Lendefs Name:
SignaNre: _
OWNER-BUILDER DECLARATIONS:
LBndefS AOdre55:
Date:
I �ereby aflirtn that untler penalry oi per�ury that I em EAEMPT FROM 7HE CONTRAC70RS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Business end Protessions
Cotle: Any ciry or counry which requires e pertnit to construct, alter, improve, tlemolish, or repair flny siructure, prior to its issuance, also requires Ihe flpplicant tor such permit
lo flle e signed stetement that he ar she Is Iicensed pursuant to the provislons oi the Contractors LJcense Law (Chapter 9(commencing with Section 7000) ol DlWsion 3 of the
Busineu entl Pratessions Code) or thal he or she Is exempt therefrom end ihe basis for the alleged exemption. Any violation of Section 7031.5 by any applicent 1or a pertnit
subjects the epplicant to e civil penalty ol not more then five huntlretl tlollars (5500)J:
❑ I, es owner ol t�e property, or my employees with wages as iheir sole compensation, WILL DO 7HE WORK, entl the structure is not Intended or oHeretl tor sale (Sec.
7044, Business end Professlons Code: The Contractors License Law does not apply to en owner of property who builtls or improves ihereon, and who does such work
himself or hersalf or thwugh his or her own employees, provided that such improvemems are not imentletl or oNeretl for sale. tl, however, the building or improvement is
soltl within one year ot completion, ihe owner-buil0er will heve the burtlen ot proving that he or she did not build or improve tor purpose ot saleJ.
❑ I, as owner of Ihe property. em E%CLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construcl Ihe project (Sec. 7044, Business end Protessions
Cotle: The comractors License Lew tloas not apply to an owner of property who builds or Improves thereon, and who contracis tor such proJect with e contrector(s)
license pursuanl Io t�e Comreclors License Lews.).
❑ I am ezempt under sec. Business antl Prolessions Cotle for �his reason:
Signeture: Date:
Owner ID verified by driver's license. ❑ Ves ❑ No Driver's License No.
Verllicetion oi Ownership �y (type ol daument, I.e. - property tex blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION:
Expires:
❑ I hereby certity ihat no excavetlon live (5) or more leet in depih into which a person is requirad to tlescenq will be made in connectlon with work authorized by this
permit, entl ihat no building simcture, scaflolding, felsowork, or demolitlon or dismantling thereof, will be more ihan thirty-six (36) teel high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ti�le 8, Celifornia Adminisiretive Cotle).
❑ As owner-bulltler, I will not employ enyone to do work which would raquiro e permit irom ihe Division ot Industnel Setety, as noted ebave, unless such person hes e
permit to do such work trom ihe tlivision.
Signeture: Date:
Division of Intlustnal Sefety Permit Number:
CERTiFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTAY: I cerlity under penalry of perjury ihat I have read this application end state ihat the information given is
correct. I agree to comply with all stete lews end city ordlnences relating to building construction, end authorize representatives ot the Ciry of Cwta Mese to enter upon Iha
ebove-descn6ed proparty for inspection purposes. I egree not to occupy or ellow occupancy oi eny builtling au�horized by this pertnit until final inspection.
COOE I' INSPECTIONTYGE �
1616 Fixed System Final Fire Prevention
1266 Pool Spa Pinal
200 Final Re-Root
201 ' Final Blak/Reteining Wall
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demalition
�E ��
COOE 1 INSPECTION TYPE
206 Final Mechanical
208
210
212
220
Final Plumbing
Final Electricel
Finel Flre Prevention
Final Planning Approval
222 Final Site
250 FinelBuilding/Occupancy
Date
Date
� INTITULS
. �� �
(714) 754-5273 • Fex (714) 754-4858 • wv+w.ci.coata-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Jobnddress: 2530 CORNERSTONELN
Suite No
Vicinity: � NEW SFD
Parcel Number: TPN30053
App�icant: GOODWYN, JIM
Address: 16845 VON KARMAN
STE 100
IRVINE, CA �
MECHANICAL PERMIT
Phone: 949-756-7373
Zip: 92606
Owner: RICHMOND AMERICAN HOMES OF CALIFORNIA
Address: � � . „ _ � �
� � � � Phone: 949-756-7373 - �
. , - . Zip: � .
Conuactor: RICHMOND AMERICAN HOMES OF CALIFORNIA INC
Address: 5171 CALIFORNIAAV
SUITE 120 Phone: 949-467-2600
IRVINE, CA Zip: 92617
' License:487535
Status: ISSUED
Applied: O6/13/2006
Issued: 06/13/2006
ISSUED BY:
SCOPE OF PERMIT -
MECHANICAL PERMIT FOR PHASE 1 CORNERSTONE HOMES .
PLAN 2AR - - � " '
CONSTRUCT NEW 1947SF 2-STORY SFD WITH ATTACHED 461SF ATTACHED GARAGE. 24SF
ENTRY PORCH. REF: BO6-00341
REF#:BO6-00914
WORK TO INCLUDEi �1 �HOOD W/MECH EXHAUST'AND 1�:INST, FAU�<+100 K BTU, 4 VENT
FAN/SINGLE DUCT AND 1 COMPRESSOR/ABSORPTION-SYST 3 TO 15 HP/500 K BTU.
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Re(rig Sys >700 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Ezhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfm
FloorFurnace
Floor or Suspend Heater
$23.50
$14.80
$o.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$70.65
$0.00
$29.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantiry
1
0
0
0
0
0
0
0
1
0
4
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Atl Atisorbtion Unit
' Repair/AltRefrigerationUnit
Ventillation Sysiem
EJaporetive Cooler
Comme rcial I ncinerator
Domestic Incinerator
- . , � ��� � Comoressors / Absorption Svstems � �
" Upto3hp/t00kBTU .
3To15hp/500kBTU
15 To 30 hp'/ 1,000 k BTU , ,
30 To 50 hp / Y,750 k BTU -
�. Over 50 hp / Over 1,750 BTU . �
� , Boilers "
Upto3hp
3To15hp
� � 15to30hp. -� '' `;�-
-30 to 50 hp . � � - , � �
. , Over 50 hp
� Other Mechanical Fee �
Investigation Fee � "
Plan Check Fee
Reinspeclion Fee �
Tf�T/�1 /�111 /�I11 1TCIl CCCC
Quantiry
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$27.15 1
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
l.1I1C .1I�
NOTICE: The work authorized by this permit shall comply with al� applicable handicap access requiremenis under Calitomia statutes and ielated
regulations. (Ord. No. 9248, § 1, 12•21-92)
EXPIRATION: Thls permit shall automatically expire and become vold if work is not commenced within 180 days, or If work Is suspended or abandoned
for a period of 1 BO days. �
INSPECTIONS: In order for ihe work authorized under this permlt to be considered legal, such work must comply with" all applicable codes, and all
requlred Inapectiona and ilnal epproval must be obtalned. failure to obtain inspactions and final approval will result in the expiration of this permil.
FOR INSPECTIONS CALL: (714) 7545626
244&AB (8�W)
WORKERS'COMPENSAnON DECLARAnON:
I hereby atfirtn untler Denalry of Derjury one ol the following declaretions:
❑ I have antl will meintain e certificate ol consent to self-Insure for workers' compensalion, as provitled for by section 3700 0l the Labor Cotle, for the peAormance of the
wark for which this permit is issuetl.
❑ I have antl wlll maintain workers' campensation Insurence, as required by section 3700 of Ne Lebor Code, for Ne peAortnance of the work for which Nis pertnit is issued.
My wo rs' compensation Insura�r�}� qw�,r�der entl p Icy number are: ��/�
Carner:�Q✓1L�[�"""P �/u✓q{�(Y PolicyNum6er:_�Y —17S
(This section n ed nof be cromplefed i! fhe permit is valuetl e( one huntlred dollers ($100) or IessJ
❑ I certity Ihat in the performence of the work for which ihis parmit is issuatl, I shall not employ eny person in eny menner so as to become subject to the workers'
compensatlon lews of Califomle, end egree Ihet II I should become subJect to t�e workere' compensetion provislons at Sectlon 3700 oi the Labor Cotle, I shall totlhwi[h
comply with �hese prav ions.
Applicam Signature: � Date: —��/� % /�h
WNRNING: FAILUFE TO SECU FKERS' WM SATION CA RAGE IS UNLAWFUL AND SHALL SUBIECi PN EMPLOYER TO CRIMINAL f�NALTIES AND CIVIL FlNES UP TOONE HUNDRED
TMOUSANDOOLLAHE(5100,000), DDITIONTOTHECOSTOFfAMPENSATION,DAMAGESASPROVIDEDFORIN5ECT10N31080FTMElABORCODE,IMEREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS OECLARATION:
I �ereby afllrm thet I em
force antl eHecL Lic. a
Contrectors Signature:
Chapter 9(commencing wi�h Section 7000) ot Division 3 of the Bi
Class N
_ Dale:
and my license is in tull
CONSTRUCTION LENDING AG6dCY:
❑ I hereby aflirm ihat there is a construction lending egency for the pertortnance of the work for which ihis permi� is issuetl. (Sec. 3097, Civil Cotle).
Lenders Name:
SignaNre: _
OWNER-BUILDER DECLARATONS:
LentleYs Atldress:
Date:
I hereby aflirm thel untler penalry ol perjury lhat I em EXEMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or county which requires e pertnit to construct, alter, improve, demolish, or repair eny siructure, pnor to its issuance, elso requires the applicant for such pertnit
to lile e signetl stetement thet he or she Is Iicensed pursuant to the provisions of Ne Contractors lJcense Law (Chepter 8(commenGng wlth Sectlon 7000j oi DlWsion 3 of the
Business and Profeulons Cotle) or thet he or she Is exempt therefrom and the basis For Ihe elleged exemption. Any Nolation oi Sectlon 7031.5 by any appllcant for a pertnit
subjeas ihe eppliwnt to e civil penelry of not more than five huntlretl tlollars (5500).):
❑ I, as owner ol ihe pro0erty, or my employees with weges as �heir sole compensation, WILL DO 7HE WORK, end Ihe structure is not Intended or oHaretl lor sala (Sec.
7044, Business and Pmfessions CoOa: Tlie Contracmrs License Law tices not apply �o an owner ol properry who builtls or improves thereon, end who tloes such work
himself or herself or ihrough his or �er own employees, providetl t�at such improvements ere not intended or oflered for sale. If, however, Ihe building or impmvement is
sold within one year of completlon, Iha owner�bullder will have the burden ol pmving thal he or sha did not builtl or improve tor purpose oi sale.).
❑ I, as owner ot Ihe property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business antl Profeuions
Code: The contractore License Lew does not apply to en owner ot property who Duiltls or Improves thereon, end who contrects lor such pmject with e contrector(s)
license pursuant to ihe Contrectors License Lews.).
❑ I am exempt under sec. Business and Professions Code tor Ihis reason:
Signeture: Date:
Owner ID veritied by driver's license. ❑ Ves ❑ No Driver's License No.
Verification oi Ownership by (type of document, i.e. - pmperty taa bill or deed):
Expir05:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION:
❑ I hereby cenify the� no excavetian tive (5) or more feet in depih into which e person is required lo descend, wlll be made in connectlon wlth work euthonzetl by Ihis
permit, end that no building simcture, scallolding, talsework, or demolition or dismantling ihereot, will be more Ihen Ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ti�le B, Californie Administretive Code).
❑ As owner-huilder, I will not employ enyone to do work which would require a pertnit from the Division of Industnal Sefery, es nototl above, unless such person has e
pertnit to tlo such work irom the division.
Signature: Date:
Division ot Industrial Safery Permit Number.
CER77FlCATE OF COMPLIANCE AND AUiHORVA710N OF ENfAY: I cenity under penalry ot perjury that I have reeC this apDliwtlon entl state that the informetion given is
correcL I egree b comply with ell stete laws end ciry ortllnances ralating to builCing consWction, entl euthorize represeniatives of the City ot Cosia Mesa Io enter upon the
ebove-descnbed properry for inspection purposes. I egree not to occupy or allow occupancy ot any building authonzed by this pertnit umil final inspection.
SignaNre Ot Legal Owner(s) Date
AnNOr Authonzed Applicanf Date
GOOE t. INSPECTIONTYGE
1616 Fi:etl System Final Fire Prevention
1266 Paol Spe Finel �
200 Finel Re-Rool
201 Final BIaWReteiNng Well
202 Final Factory Fire Place
203 Finel Sign
204 Finel Domolitlon
Q� � IMRIpLS
C9DE� INSFECTIONTYPE
206 Final Mec�anicel
20B Finel PlumDing
210 Final Electricel
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Site
250 � Final Building/Occupancy
ADAMS • STREETER
CIVIL ENGINEERS INC.
November I7, 200G
City Grading Inspector
City ol' Costa A1esa
Dcvclopment Sen�ices Department
77 Fair Drive
Costa Mesa. C:ilifornia J362S-1?00
U5-1573
IRVINE • RIVERSIDE
Jan A. Adams • Randal L Streeter
Subject: Civil Lngineer's Certitication of Precise Grading
Yroject: 'fract No. 16937 — Lots 6, 7 aincl8- 13uildings 20 ihrough 31
Cornerstone at I�larbor 13h�d.
Costa ]19esa, Calil'ornia
Refi'rence: Rough Grading Purmit Number. CO(-00003
Address: 2�01 Harbur Boulecard, Costa A4esa, California
O«�ner : Kichmond American Homes
Ceneral Cuntractor: Richmond American Homes
In accordancc �vith City of Cosl.� Mcsa Grading :md Gxcavation Codc, and thc
rcyuirements uf thc Buil�in� Code, 1 certify .ipproval oF this piaject as outlined t�bo��e, to
precise grade. Precise grading h:�s heen eompleted in conform:ince ���i�h .ippro��ed precise
gr.iclint� plan for this projcct and in full compliance ���ith s.iid Codes. Certific.ition
includes horiz.ontal and ve�7ical control for druinaee devices; ❑nd posili�'e buildin� pad
drtti n a�e.
�--�
This .ipprovul docs not includ �f���l4�q� compac[ion ol soil, �vhich is under the
pur��icw of thc soil en�ineer. �Q-`�� �pMOHq�r� F�,�
13 v:
�1. Mohammudahadi, Project
Adams Streeter Civil 6n�inecrs Inc.
No.426�5
Eap. 3-3t-OB
OF C�'-
� No��embcr ll. 200C
a361i (Exn.3l3U0S)
15 CORPORATE PARK • IRVINE, CA. 92G06 • Te1: t949) 474-2330 • Fax: j949) 474-0251
2900 ADAMS STR[[T, SUIT[ A-400 • RNERSIDE, CA. 9250� • TeL (951) 352-4100 • Fax: (951) 352-6200
ption �
�' �ne
a� orsrzcrr,ve e.vei,. ee� xs PAGE I OF I
,., :.: . . . . _ .. � _ . : . . .. .... . � . _
�fi ' < STRUCTURAL OBSERVATION REPORT,FORM . '
�� ; .,,_ _ _„ _ � RICHMOND AMERICAN;HOMES ,_� M . _ .. � _ _,;.;
THIS REPORT MCLUDES ALL CONSTRUCTION WORK THROUGH THE: I S'" Dav of Scptcmbcr 2006.
PROJECT:
LOCATION: -
OWNER:
ARCHITECT:
STRUCT.OBS.OFRECORD:
STRUCTUR:IL OBSERVER:
'�Cumersmne"-SPD
Costa hlesa. California
Richmond American Homes
Ruscnian I.agoni Architmts
Garv,a. McClanaha�i, P.E.
CIitTJones, E.I.T.
OPTION ONE 1.N.: 0106-1253
BLDG. PERMIT No.:
LOCATION/DIVISION: Orange Caimty
ARCHITECT 1.N.: RI.A-5165
LIC. or REGISTRATION Nos.: C-32i53
GIT- 113962
i: LOTfS) & PHASE OBSERVED:
Inlcriur and Es[erior CcnerAl Framingi i.e., roof Uusses, roo(sheathing, Lo[ 22, Plan 2AR, 2530 Cumersmne Lane,
s'hear elements', holdowns, lloor sheathing, floorjois�s/kusses, bemns, heaJers. Phaie l, 7ract N 16937,
andgeneralhardware. � Cos[aMesa,California �
ORSF,RVEDDEFICIEtiCIES: (ArraceaoomoNatraGeSiFNeCessaen InitiallComoletionDa[e:
"f he deficiencies anNor mn-conforming items no[ed during observa[ion visit have been correc[ed CPJ/09-/9-0(
and ins[alled by a collaborated eftort of the pmject superintendent and the frunino toreman.
Construction " �-9euble-Si6e9 0 Plywd CI'g 9—Beek
Stage: 0 HVAC 0 Electrical � Plumbing c�.e..�n,�.... Lid(s) 9�6ien
Note; When box is checked, it indicates thaf consfmction sfage is in prog�ess, and A has not yel 6een complefed af the fime observation was conducled.
0 STRUCTURALSYSTEM WASVISUALLY OBSERVEDTOBEiNGENERALCONffORMANCE WITHTHEAPPROVEDPLANS.
❑ STRUCTURAL DEFICIENCILS AAE OF A MINOR NATUAE & MAY BE AEVIEWED BY CITY BLDG MSPECTOR FOR COMPLIANCE.
I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OR MY IGYOWLF,DGE & BF,LIER:
l. I A,�I THE REGISTERED ENGINEER WHO HAS RESPONSI➢LE CHARGE
FOR THE STAUCiURAL OBSERVATION.
2. I, OR ANOTHER QUALIFIED-CHARGE OBSERVER WHO 1 HAVE
DESIGNATED ABOVE AND IS UNDER MY RESPONSBLE CHARGE,
HAS PERFOAMED THE REQUIRED SITE VISITS AT EACH
SIGNIPICANT CONSTRUCTION STAGE TO VERIFY IF THE
STRUCTURE IS M GENERAL CONFORMANCE WITH THE APPROVED
PLANS AND SPECif(CATIONS.
3. Af.L DEFICfENC1ES, WHICH I DOCUMEi ITED, HAVE BEEN CORRECTED
UNLESS OTHERWISE INDICATED ABOVE.
4. ALL OBSERVED DHFICIENCES SHALL SF, CORRHCTED AND
APPROVED BY THE OBSERVER PRIOR TO FRJAL ACCEPT.WCE OF
THE STRUCTURAL SYSTEb]S BY THE BUILDING DEPARTMENT,
5. TH(S REPORT IS PROVIDED TO THE 0��'NER AS A PART OF THE
OWNERS OVEAALL CONSTRUCTIOV QUAI.ITY CONTROL PROGRAM.
6. OPT[ON ONE HAS PROV[DED STRUCTURAL OBSERVATION M
ACCORDANCE WITH THE SEAOC RECOMMENDED GUIDELIhES FOR
THE PRACTICE OF STRUCTliRAL ENGNEERING M CALIFORNIA.
�I" N° � 042553 ZI*
\ Exp. 03/31 / OS�
STAMP & WE7' SIGNATURE OF
STftUCTUI4ILOBSERVlROFRECORD
SIGNEDBY: � l5'"DayofSeptember?OOG.
S7'RUCTURAL OUSEHVATIO,�' DOES NOT WAIVE THE REQUIREMENTS FOR MSPECTIONS BY CITY BUILDING
INSPECTORS. ALL WORK A1UST COMPLY WITH THE APPROVED PL.4NS AND APPLICABLE STATE & LOCAL CODES.
G:11200's1125310bservationlPhase_11SOR_P_Lot 25_P3BR.doc (Rev. i15105)
Option One Tel 949.553.1916
Consulting Engineers 20311 Acacia St., Suite 240, Newport Beach, Ca. 92660 Fax 949.553.9720
(714) 754•5273 • Fax (714) 754•4856 • www.ci.costa-mesa.��MBING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2530 CORNERSTONE LN
Suite No
Vicinity:
ParcelNunmber: TPN30053
Applicant: GOODWYN, JIM
Address: 16845 VON KARMAN
STE 100
IRVINE, CA .
ISSUED BY:
Phone: .949-756-7373
, Zip: 92606
owner: RICHMOND AMERICAN HOMES OF CALIFORNIA
Address
Phone: 949-756-7373
Zip:
Slatus: ISSUED
Applied: 06/13/2006
Issued: O6/132006
�, � �_.`, . " � ' _
Contractor: RICHMOND AMERICAN HOMES OF CALIFORNIA WC �` ,
Address: 5171CALIFORNIAAV . � � .-�.
SUITE 120 Phone: � 949-467•2600
IRVINE, CA Zip: �`92617
License: �487535 �
SCOPE OF PERMIT
PLUMBING PERMIT FOR PHASE 1 CORNERSTONE HOMES - � ��
PLAN 2AR "
CONSTRUCT NEW 1947SF 2-STORY SFD WITH ATTACHED 461SF ATTACHED GARAGE.24SF ENTRY
PORCH. REF: BO6-00341 � �
REF#: BO6-00914
WORK TO INCLUDE: 1 BACKFLOW IRRIGATION, 1 BATHTUB, 1 DISHWASHER, 1 GAS (1-4
OUTLETS), 1 GAS SERVICE, 1 LAUNDRY TUBNVAHSER, 1 LANDSCAPE IRRIGATION, 1 SEWER
CONNECT, 1 SEWER PRIVATE LINE; 2 SHOWERS, i KITCHEN SINKS, 5 WASH BASINS, 3 WATER
CLOSET, 1 WATER HEATERNENT AND 1 WATER SERVICE. - - ` .
ISSUE FEE
BackOow irrigation
Backflow Preventer
Balhtub
Clarifier System
Connect (Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drein, Roof
Drinking Founlain
Expansion Tank
Gas Earthquake Valve
Gas (1 � outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oip
AMT
$23.50
$9.80
50.00
59.80
50.00
50.00
50.00
$9.80
$0.00
50.00
50.00
50.00
50.00
50.00
56.15
50.00
50.00
59.80
So.00
arr
FEE SUMMARY
AMT QTY
Laundry Tub / Washer � $9.80 1
Landswpe Irrigation � . $14.80 1
P-Trap . ��� • . $0.00 0
Pressure Regulator $0.00 0
Process Piping (per 10 fl) $0.00 �. 0
Receptors . � $0.00- '.O.�c
SepticTank $0.00 0 �-
Sewer Cap for Demo � $0.00 0
Sewer Connect $24.65 1
Sewer Private Line $24.65 7
Shower $19.60 2 -
Sink, bar $0.00 0
Sink, wmmercial $0.00 0
Sink, Floor $0.00 0
Sink, kitchen $9.80 1 �
Sink, service/mop $0.00 0
Spa (private) � � 50.00 0 -
Spa(public) 50.00- 0� .
Sump Pump
Swimming Pool
Trap Primer .
Urinal "
Vacuum Brkr Bktlow(1-4)
� � � ��- Vacuum Brkr Bkflow(5+)
Wash Basin
, Wash Basin Set .
- Waste and-Vent System
' WaterCloset(Toilet)
� � Water Heater / vent
' , � Water Piping (Inst or Rep.)
� � Water Re-pipe��
Water Service
Water Softener
OTHER
" - VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00 �
$0.00
$0.00
$0.00
50.00
$0.00
$49.00
$0.00
$0.00
$29.40
$72.30
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
�
0
0
0
0
0
0
5
0
0
3
1
0
0
0
0
0
N0T10E: The work authorized by this permit shall compty with all applicab�e handicap access requirements under Calilomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automaticaliy expire and become void if work is not commenced within 780 days, or if work Is suspended'or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must compty with alI applicable codes, and ail
requlred Inspectlone and flnal epproval must be obtained. Failure to obtain inspeclions arM final approval will resutt in ihe expiration of th(s permit.
FOR INSPECTIONS CALL: (714) 7545626
2uaas �a�oo�
WORKERS'COMPENSAnON DECLARAnON: �
I hereby aHirtn under penalry of perjury one of ihe following declarations:
❑ I heve end wlll melntein e certllicate ot consent to self-Insure for workers' compensation, es provided for by section 3700 of ihe Lebor Code, for the peAortnence oi the
work tor which Ihis permit is issuetl.
❑ 1 have antl wlll maintain workers' compensation insurance, as require0 by seclion 3700 of Ihe Labor Cotle, for Ihe peAortnance of the woM for whicti this pertnit is issued.
My worke compensation InsurenceI �rrier antl policy umber are: ��
Certier. �✓ � La.... /�U�'✓� �SSfL� ✓1f 'P Policy Number. G-. U �� I�
(This section need nof be comp/etetl i! fh p'ermit is velued ef ne hundred dallers ($100) or /ess.J '
❑ I certify t�et in ihe peRormence of t�e work foi which ihis permit is issuetl, I shell not employ eny person in eny manner so as to becoma subject to the workers'
compensation luws ol Celifomia, end egree that If I should become subject lo the workers' compensation provislons of Section 3700 of the Labor Code, I shall fort�with
Comply with Ihese pr vl5io'S. � ^ !/
Appliwnt Signature: 1C pST7� oece: '� /�/�b
WAfiNING: FAILVRE TO SECU WORNERS' COMP ON COVERAGE IS UNLAWFUL AND SHALL SUBIECi AN EMPLOVER TO CRI�MINAL PE TIES AND CIVIL FlNES UP TOONE HUNDRED
TMOUSANDDOLURE�5100,000 NADDRIONTOTHECOSTOFCAMPENSATIdJ,DNMGESASPROVIDEDFORINSECTION37080FTHELA80RCODE,IMEPEST,ANDATfORNEVSFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm ihat I am
force antl eNect. Lic. a_
Conirac�ors Signature:
9(commencing with Section 7000) ot Division 3 of Ihe Busin s antl Pmfessions Code, and my license Is in full
Class a � � .
Date: �n i']
CONSTRUCTION LENDING AGYNCY:
❑ I hereby eHirm Ihat there is a construction lendinq agency for the peAormance of ihe work lor which this permit is issued. (Sec. 3097, Civil Cotle).
Lentlers Name:
Signature: _
OWNER-BUILDER DECLARATIONS:
Lendefs Adtlress:
Data:
I hereby ettirm ihat under penalry of Derjury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or counry which requires e permit to construci, alter, improve, tlemolish, or repair eny structure, pnor to its issuance, also requires the applicant lor such pertnil
to file a signed sietement thet he or she Is Iicensetl pursuant to the provislons ot the Contrectors LJcense Lew (Chapter 9(wmmencing wlih SacUon 7000) oi Divislon 3 of the
Business antl Prolesslons Code) or Ihet he or she is exem0� �herefrom and Ihe besis for Ihe elleged exemption. Any violetion oi Section 7037.5 by any epplicent for a permit
sublecis the epplicem to e civil penelty of not more ihan tive hundred dollars ($500)J:
❑ I, es owner of ihe property, or my employees with weges as iheir sole componsatlon, WILL DO THE WORK, antl ihe slrucNre is not Intended ar oHered tor sele (Sec.
7044, Business end Professions Code: The Contractors License Law tloes not apply to en owner of propeny who Duiltls or improves ihereon, end who does such work
himself or herself or ihrough his or har own employees, providetl �het such Improvements ere no� In�ended or oNeretl for sale. If, however, the building or Improvemant is
soltl within one yeer of completion, the owner-builder will have the burden ol proving ihat he or she did not �uild or improve tor purpose of sale.).
❑ I, as owner ol the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7046, Business entl Prolessions
Code: The contractors Llcense Lew tloes not appy to en owner of property who bullds or Improves Ihereon, end who coniracts for such project wlih e coniractor(s)
license pursuant to the Contrectors License Laws.).
❑ I am ezempt under sec.
Signature:
Ownet ID venfietl �y tlriver's license. ❑ Yes ❑ No
Business antl Professions Cotla for �his reason:
Verilice�ion of Ownership 6y (rype of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICA710N:
Driver5 License No.
Date:
Expires:
❑ I hereby ceriify that no excavatlon live (5) or more feet in depih into which e person is requirad to descend, will he made in connecilon with work euthorizad by tNs
pertnit, and that no building structure, scafloltling, talsework, or demolition or tlismantling thereol, will be more than thirty-six (36) teet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Ttle B, Californie Adminisiretive Code).
❑ As owner-builder, I will not employ anyone to do work which woultl reQulre e Dermit Irom ihe Division of Indusirial Safery, as notetl abova, unleu such person has a
pertnit to do such work irom the division.
Signawra: Date:
Division of Industrial Safety Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUfHORVATION OF ENTRV: I cenify under penalty ol per�ury that I have reatl this ap0licatlon entl state that the informatlon given is
correct. I agree to wmply with all slate laws and ciry ordinances relating to tullding construction, entl au�horize representatives ot the Ciry ol Costa Mese to emer upon the
ebove-tlescribed properry for inspection purposes. I agree nm m occupy or allow occupancy ol eny building authonzed by this pertnit unlil linel inspection.
GODE /, INSFECiIONTHIF
1616 Fixed System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Root
201 Final8locWRe�aining Wall
202 Final Factory Fire Place
203 FinalSlgn
204 Final Damolition
� � vb �etB
Date
Qd¢, INTRIALS fQj�f„a INSPECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Eleqnwl
212 Final Fira Prevention
220 Final Planning Approval
222 FinalSite
250 Final Building/Occupancy
P� It�48
V�l�� 1• �.. ...