HomeMy WebLinkAbout3024 WARREN LN - Building Permits . )'• - I i
`A MF CITY OF COSTA MESA
BUILDING DIVISION
Y%f�,,,,. t. DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER
I .I� I PERMIT
41t.bieftwilso w"
B01-00638
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesasausLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 3024 WARREN LN BUStatus: ISSUED
Suite: Applied: 05/07/2001
Vicinity: RESIDENCE 8 ATTACHED GARAGE Issued: 05/07/2001
Parcel Number: 14116507 Zoning: R1 R1
_7.&A_
Applicant: LIVINGSTONE, TERRY ISSUED BY:
Address: 177 RIVERSIDE AV -
Phone: (949)645-0104
NEWPORT BEACH,CA Zip: 92663
Owner: TOOL, MARSHA
Address 3024 WARREN LN
Phone:
COSTA MESA, CA Zip: 92626
Contractor: NEWPORT ROOFING INC
Address: 177 RIVERSIDE AV
Phone: (949)645-0104
NEWPORT BEACH,CA
Zip: 92663 License: 524454
Arch : - Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT.
REROOF:I/O EXISTING COMP ROOF,REPAIR SHTG AS NEEDED, 1 LAYER 15#FELT,APPLY 30-YEAR"GAF
TIMBERLINE"COMP SHINGLES. 21 SQUARES -
- FEE SUMMARY -
Plan Check: $0.00 Calc Valuation: $3,995.00
Permit: $97.25 Claim Valuation: $3,995.00
SMIP Res: $0.50 -
SMIP Com: $0.00
Other: $0.00
•
Inspection: $0.00 ' -
Total: $97.75
' .
: .-.
' ---.- PLANNING &ZONING —.
SETBACKS -
MAIN STRUCTURE Front 0-0' Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0- Right 0-0
PARKING Existing: 0 Required: '0 Proposed: 0 '
NOTES: " "
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 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
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(WOO)
DECLARATIONS
WORKERS'COMPENSATION DECLARATI.,..:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
0, I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: _— Policy Number:
(This section need not be completed if the permit is valued et one hundred dollars($100)or leu.)
❑ I certify that in the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,a agre•that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions.G: _ J' /O,
Applicant Signature: Date: N`ASL'//
WARNING FAILURE TO SECURE WO- - 'COMPENSATION COVERAGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYER TO GRIM! PENALTIES AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE($l00,000),IN ADDDION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full
force and effect.Lic.M m Class#
Contractors Signature: //C t39 Date: r 7f0 /
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the 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 therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty 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 the structure Is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the 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.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of properly who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑Yes ❑No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No
(Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
....the South
Air Quality
ria e e.....
7 Ifa a permit athe South Coast reManagement District or other airtpollution control district03 agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Ves ❑No
8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signa O egal Owner(s) '7 Date
�fy
Or Auth/forizetl Applicant s/!/0
Date
CODE I INSPECTION TYPE OATS INTITIALE POPE, INSPECTION TYPE PATE INTITIALE
1616 Fixed System Final Fire Prevention _ _ 206 Final Mechanical
1266 Pool Spa Final / 208 Final Plumbing
200 Final Re-Roof 4`f?—O( 4u'ti- 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
L'l ; t CITY OF COSTA MESA , y
46 BUILDING DIVISION
F ____ DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER
O W+ PERMIT / E03-00995
et 1
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
ELECTRICAL PERMIT
Job Address: 3024 WARREN LN Status: ISSUED
Suite No Applied: 10/22/2003
Vicinity: - Issued: 10/22/2003
Parcel Nunmber: 14116507
Applicant: YAGERLENER, CHRISTOPHER JOHN ISSUED BY: /7----
Address: 3024 WARREN LN
Phone: 949-433-8733
COSTA MESA,CA Zip: 92626-5245
Owner: YAGERLENER, CHRISTOPHER JOHN
Address 3024 WARREN LN
Phone: 949-433-8733
COSTA MESA,CA Zip: 92626-5245
Contractor:
Address:
Phone:
Zip:
License:
r SCOPE OF PERMIT
UPGRADE ELECTRICAL SERVICE TO 200 AMPS.
FEE SUMMARY
•
Quantity 4 Quantity
ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0
Temp service test $0.00 Busway/100 ft $0.00 0
Res.a/c package $0.00 Standing Section $0.00 0
New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0
New Res(3+units) $0.00 0 . Transformers up to 1 kva/kw $0.00 0
Pool/Spa $0.00 0 - up to 10 kva/kw $0.00 0
Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0
Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0
Switches $0.00 0 i, over 100 kva/kw - $0.00 0
Non Res Appl $0.00 0 • Low Voltage Equipment $0.00 0
Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0
Service to 200a $30.50 1 i Misc.Conduit $0.00 0
Service to 1000a $0.00 0 Misc.Conductor $0.00 0
Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0
Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0
Motors to 10hp $0.00 0 Christmas Tree Stand i $0.00 0
Motors to 50hp $0.00 0 Fireworks Stand $0.00 0
Motors to 100hp $0.00 0 Other Electrical Fee $0.00
Motors over 100hp $0.00 0
Communication drops $0.00 0 Investigation Fee $0.00
Sub panel to 200a $0.00 0 Plan Check Fee $0.00
Pole Light Pkg $0.00 0 Reinspection Fee $0.00
Sign Circuits $0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 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
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244646(6/00)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'comprlhsatlon Insurance carrier and policy number are:
Carrier: Policy Number:
(This section need not be completed it the permit is valued at one hundred dollars($100)or less.)
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California,and agree that If Ia uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with the ovisions ^�
Applicant Signature: m V�11f-� Date: 10 - gma-'—� J
WARNING:FAILURE TO SECURE WORKER •M' •TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($10 , ).IN ADDITI•• 0 • T OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# Class#
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: _ Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the 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 therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500),):
O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the 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.). •
XI,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
O I a pt unde ).... a Business and Professions Code for this reason:
Signature: k. � �i�rw_W_ • • (1 Date: 10 —>4)-.— c)
Owner ID verified by dnvers lie: Yes ❑No Drivers License No. • Expires:R- —Ot
Verification of Ownership by(t d•;w en i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,Califomia Administrative Code).
O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health end Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature end pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? t�Yes t�No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(if'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code),
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
ab•v: •scribed•ro•'rty for inspection p op, es.I agree not to occupy or allow occupancy of any building authorized by this
permit until final inspection.
a. 1 p -- 912— —O
iW.! :tura Of Legal Owner(s) Date`
And/Or Authorized Applicant Date
CODE II INSPECTION TYPE GAME INTITIALS CODE# INSPECTION TYPE PATE ItMALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical ii ba
15 p pi1
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
.t, Applicant to fill in all spaces except those within heavy border lines inti sign an•nn ` /' - --
CITY OF CnSTA NiESA - ' • IT NO 4-•- TRACT NO. LOT No. _o M3. --
' CO;ISTRUCTION PERMIT — �l`3`� )?ui/� f} 72 7395 10/17!73 I irs 5': TL
Project Address 7 TYPE OF CONSTRUCTION Li NEW I_ ADD ❑ ALTERATION LI.REPAIR ,. _6
Applicant's Mailing Address r /5•(T •A/F.41.W �- ❑ CONVERSION ❑ DEMOLISH ❑ OT1ER. q,p-# t// / _07 Zone I
Owner's Name -On` - Phone DESCRIPTION OF WO•K _ SSP v s. n'
/ , / /�
�
�` _ S Main Building: Accessory Building: Z
•AddressE Il / _ J 0
TYPE OF PERMIT GRADING 'FOUNDATION ❑ STRUCTURAL Front 1C.L7 L� N
Arch/Eng. • License No. ❑ TENANT 12 LECTRICAL ❑ PLUMBING. El MECHANICAL . B Rear '7/ I
Address - • ❑ •OTHER • A - • N
C Right G
Contractor's Name C e✓e.- evicts . Phone 96 V,r7R PROJECT DESCRIPTION SQ. FT. G--P 5----. OCCUPANCY 'N��— K R
Address(mailing) 2/ :.) f EG l/LutsA � , CONSTRUCTION TYPE VALUATION$ xt..l' Q��- s Left C/0 / - _ E
ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ ' G
City License No. _ •
U
LICENSED CONTRACTOR DECLARATION Remarks: • Parking Req,/Provided 1 ,
I hereby affirm that f am licensed under provisions of Charter 9 (commencing _ R
with'section 7000) of Division 3 of the Business and Professions Code,and Use of Building: - E
my license is in full for a and effect. .
License Clas . ense N•. 0o.7 PLUMBING FEES Planning Notes: M
Date - Signature al as . _ . a E
WORKERS'COMPENSATION DECLARATION Bar Sink Showers N
T
' hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink • S
Workers' Compensation Insurance, or a certified copy thereof (Section -
ae00, Lab. C �- ( ,� Backflow Irrigation Sewer Cap •
- ELECTRICAL - FEES
Poky No. t -C go y4 75 Company _7d.s -sf -rw>. .
•
l Certified copy is hereby furnished. c 0.47/44: / /JL✓ /GS - Bathtubs Sewer Connection Automatic Washer Transformer 0 15-50 KW
.S., - Certified copy is flied with the city$ it ng Div oh- 0 50+KW
Date//1-Y7 �1'-� Applicant �T•-r /`��/JaZ Clarifiers • Solar Collectors Construction Pole Sub.
.EXEMPTION FROM WORKERS'COM PE NSATI DEC LARATIA ON ` ' •
Dishwasher • -Solar Piping - - -' - ' CookingUnit • - Meter ❑u to 100 amps
(This section need not be completed if the permit is for one hundred ($100)or P P '
l less). ' •
I certify that in the performance of the work for which this permit is Issued,I Solar Tank Dishwasher Meter Dover 100 amps,
shall not employ any person in any manner so as to become subject to the Drinking Fountains
mt Workers:Compensation.Laws of California-, • Floor Drains Swimming Pool w/Spa Dryers OGas ❑Electric Sub Panel
Date Signature ,
I NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan •Motors 00-1 HP ❑1'/a-8
Workers' Compensation provisions of the Labor Code, you must forthwith
h comply with such provisions or ,this .permit-shall be'deemed revoked. Gas Service -Outlets Water Closet ' . F.A.U. Inc.Solar 09-15 HP❑16-15+
CONSTRUCTION LENDING AGENCY'- _ ,
I hereby affirm that there is a.construction lending agency for the performance • Interceptors Water Heater Fixtures • Microwave •
of the work for which this permit is issued, (Section 3097 Civ. C.)
Lender's Name Kitchen Sink -
Water Service Device Boxes Pole Light
Lender{ Address Lavatories' v(�
OWNER BUILDER DLles' /"
ECLARATION _ - • - Outlets Range 2 at
I hereby affirm that I am exempt from the Contractor's License Law for the —P-Tra • -
following reason (Section 7031.5 Business and Professional Code : Any city or p . . - Switches Sign
county which requires a permit to construct,alter,Improve,demolish or repair f . -
any structure, prior to its issuance, also requires the applicant for such permit Roof Drains Garbage Disposal Standing Sections
.to file a signed statement that he/she is licensed pursuant to the provisions of _ -
the Contractor's License Law(Chapter 9(commencing,with Section 7000)of • Generator ❑0-5 KW❑5.15 KW Trash Compactor
(vision 3 of the Business and Professions Code) or that he/she is exempt P
erefrom and the basis for the alleged exemption. Any violation of Section 1 -
J31.5 by any applicant for. a' permit subjects the applicant to a civil 'Reins Reinspection Fee 3
LJendlty of not more than five hundred dollars($500). i PB I $25 - Issue Fee $
I, as,owner of the property or my employees with wages,as their sole - , • Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work, and the structure Is not Intended or offered 1 I MECHANICAL - FEES - .
•
for sale (Section 7044, Business and Professional Code: The Contractor's - --- - . --- - - -' PUBLIC SERVICES REQUIR MEN S: •
License Law does not apply to an owner of a property who builds or improves ' Boiler ' Hood or Type I 0 - YY11 EE// �/' / D
thereon, and who does such work himself/herself or through his or her own Zoning Approved By aid( (//Ti Dat�Q(l7/Q
employees, provided that such improvements are not intended or offered for Canopy Type II ❑ {�
sale. If, however, the building or improvement is sold within one year of cam- Duct-Under Ground Application Approved By Date
pletlon, the owner will have the burden of proving he/she did not build or im-
. prove for the purpose of sale). Duct-Structural Refrigeration System Application issued By Date
LJ I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUryM)SIAARY OF FEES /
The Contractor's License Law does not apply to an owner of property who - BUILDING PERMIT $ OQ`L•L0 SMIP $ D•S9ti_
builds or improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration �T•SZ
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ T PERMIT
❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# , PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting PLAN CHECK •
$ ENERGY P.C. $ •
1 hereby certify that I have read this application and state that the above ❑O-100,000 BTU 0100,000 BTU ELECTRICAL $ OO GRADING $
Information-Is correct. I agree to comply with all city and county ordinances - - -- - - - - -- •-
•
and state laws relatingito building construction,and hereby authorize repre- $ • pp MICROFILM $
sentatives of t.is ci to enter' the above-mentioned property for - PLAN CHECK
inspection / •ose / Q p
Signatures' ./..,y yr ✓ I ��L - Date M-0,--)9 MECHANICAL ' $ TOTAL FEE $ �7•.TO
Drivers' License or$ yfr ' - _ Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK • $ ,
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor . - . -- - - , - . 1 - -
7/3
'I
i CONSTRUCTION AND PLANNING P00. SPA
.. APPROVALS Permit# 66 f/.55- Date Inspector APPROVALS Permit# Date Inspector
• 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Cond• uit Utility-Undrgrnd. • 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement - 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings be A_,....... �-tr • 1A/a7/5., ' cc 58. Electrical Conduit-Undrgrnd.
8..:Foundation �1 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System . -61. APPROVAL TO DECK ,
11. Property Sewer Line & House Connection i 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater.& Vent-Final
13. Roof Drains 64. Plumbing System - Final ^+'Y •.
14. Rough Plumbing 65. Electrical-Final `a , �
15. Rough Electrical-Conduit • 66. Solar System-Final
16. Rough Electric Wiring 7f/1/43 ec 67. Fencing &Access Approval •
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
98. Roug 'Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory'Fireplace . I APPROVALS Permit#_ . _
21. Ducts, in Structure 70. Underground Hydro
'22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing • 74. Overhead Hydro
(26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical --`•
i
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding • 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall'Nailing - . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
r •
32. Electrical PowerMeter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric 11/� k3 C.0 Notes:
34. Final Heating & Air Conditioning ( I j
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final -I . -
41:Solar Domestic-Final
42. Backflow Preventer - ••
43. Backflow Irrigation
44. .Landscape Irrigation System •
45. Sound Attenuation
46. Hanaicap Regulations
i 47. FINAL STRUCTURE & BUILDING J�_3_ Q
) 53 u
48. Special Requirements Completed
49.. Electric Release to Edison
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY -
No. Date
OWNER College Mesa Co. DATE 9/21/55
JOB ADDRESS 3024 Warren Way BUILDING PERMIT NO. 1833
GENERAL CONTRACTOR Hale Co. VALUE $ 8,000.a
LOT 78 BLOCK TRACT 2'3141
GROUP I TYPE V ZONE Rh FIRE DISTRICT APIR57
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Footing Trench are . `, c •
Foundation Forms and Grade to Cara e. p-17-3)
Rough Framing / .- ,!Sd
Plumbing,Rough tdeStr ltyl //- /7., -1--' / _ 2, '/
Plumbing,Rough Complete yw f) -. 74-- ' y.c y )4471... ,�& /3=
r. i,- fes y-
3 ,2, 0
Temporary Pole a
.v
Wiring, Rough /fit. .- /_ 5(-5 , 72 e .n...--a l J.u/ /,'-/.2-ft / 7 4Z 7
Heating, Rough
He.tin_. Final eft--aft-nn Jo- 7-SS' ?083 V /
Sewi nous- - Sewer, St. Qty C-,--t C. 7/- a3 -S-S- �.rl 7 6--
Septic Tank or esspool U/
Lathing, In_ Out aff-f /---711S,
Plastering Ar 2 -t - 1
Plumbing,Final,Fixtures Complete /, /CC/�
/Y,l.
Plumbing,Final Gas Test LI /
� Ar _
Wiring,Final ar- SC'
Occupancy „Iv.td/ N-/y Sy
P.......01 ll f' L 1 Slll\l Sr: