HomeMy WebLinkAbout1332 WATSON AVE - Building Permits •
CITY OF COSTA MESA
F . BUILDING DIVISION
F77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
0-41
J•4 �'• FOR INSPECTIONS CALL:(714)754-5626
PERMIT NUMBER: M10-00036
PERMIT TYPE MECH STATUS: ISSUED
APN: 14103612 DATE ISSUED: 04/14/2010
ISSUED BY: CAC
JOB ADDRESS: 1332 WATSON AV CM Suite/Unit:
Vicinity: -
SO. FT: 0 •
SCOPE OF WORK: REMOVE AND REPLACE EXISTING FAU <90 K BTU AND REPLACE ALL THE DUCT SYSTEM
OWNER: GREER,WARREN BRACK TR Address: 1332 WATSON AVE Unit:
PHONE: 714-540-6171: City/State/Zip: COSTA MESA,CA
APPLICANT: LAURA YENULONIS . Address: 1225 GRAPHITE DR Unit:
PHONE: 951-280-3113 City/State/zZip: CORONA,CA
CONTRACTOR: ARS AMERICAN RESIDENTIAL SERVICES License No. 645050 1110-000366
Address: 1225 GRAPHITE DRUnit: PHONE: 951-280-3113
City/State: CORONA,CA ZipCode: 92881 , ' - CELL: •
•
•
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $52.00
PLAN CHECK FEE: $0.00
INVESTIGATION FEE: $0.00
REINSPECTION FEE: $0.00
,- ;l_M
TOTAL FEES: $52.00
11 -t-(.11Y,:;
•
•
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION,
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.
CODE S. INSPECI1ON TYPE DATE INTTALS CODE[ INSPFC710N TYPE, D .: INi1TIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
e -/o b7 �,
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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
k e , r :•
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
pe rmance of the work for which this permit is issued.
d
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
too-re:�'��n�\ " `_ S I r
personthis is reand to desno buil will bmade in connection, a with worka authorizedm
-CJr ` sx,N L-l) by this permit,and that no building structure,scaffolding,falsework,or demolition
This seaon need not be competed n the ermrt is valued at one hundred dollars(5100)or less) or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gm
�f p\¢ 2,Art 2.Sec. 341,Title 8,California Administrative Code).
PolicyOi ser: l(0� Sl` .Skop Ct a 0 As owner-builder, I will not employ anyone to do work which would
O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
Applicant's Signature Date
e Labor Code,I shall fo• with comply with these provisions.
Nlii
' ' ` ' ` 10 Division of Industrial Safety Permit Number:
ppli Wre
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: R 0 SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST. AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions ode, and 2. Does or will the applicant or present or future building occupant need to file
m ense is infullforce and effect.
CIO
^ ^ a registration form for acutely hazardous materials? 0 Yes 0 No
�c{_)�� " CIO 2-V (Section 25533 of the California Health and Safety Code, with some
tr.\. tT exceptions, requires registration with the Costa Mesa Fire Department by
5 0�(�i X ��lv each business which at any one time has on hand a quantity of acutely
Dina rs gnawre ate 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
CONSTRU LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safely Code been fully complied with? ❑Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application. have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No
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 8. (If"yes",attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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.
Si nature of Legal ner(e) Date�'1��lO
Signature Date •
3057<6(3/01) —
At nem npnxed Applicant Date
•
- - . -,- -
Simplified Prescriptive Certificate of Compliance: 2008 Residential HVAC Alterations CF-IR-ALT-HVAC
Climate Zones I and 3-7
Site Address: EnforceTenl Ag_encr: Dale: Permit ti:
\'b32. \,00,.\\-bon isrse- ( �5,\Cl CI�Sa 'It-14-to
Conditioned Duct insulation
Equipment Type'Type' List Minimum Eflicicnev' Floor Area requirement Thermostat
❑Packaged Unit
poFWiaCC AFUL qqC ❑COP tve�S40.ft.of—duct'
s
Served by system adtled or replaced in Xetback
❑Indoor Coil ❑SEER 0 HSPFsf u ndihoned space (nmol already present,must be
0 Condensing Unit 0 EER 0 Resistance r R 6 (CZ 1, 3-3) installed)
❑Other
I. Equipment Type:Choose the equipment being installed;if more than one system,use another CF-IR-ALT-HVAC for each system.
2.Minimum Equipment Efficiencies: 13 SEER,78%AFUE,7.7HSPF for typical residential systems. •
Contractor(Documentation Author's/Responsible Designer's Declaration Statement)
• I certify that this Certificate of Compliance documentation is accurate and complete.
• I am eligible under Division 3 of the California Business and Professions Code to accept responsibility for the design identified on this
Certificate of Compliance.
• I certify that the energy features and performance specifications for the design identified on this Certificate of Compliance conform to the
requirements of Title 24,Pans 1 and 6 of the California Code of Regulations.
• The design features identified on this Certificate of Compliance are consistent with the information documented on other applicable
compliance forms,worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with the permit
application.
Name: Lk\n_nt _ th Signature: ,
Company: !� �� ,1�ate. LA k J 0
Address: I� License:
\gas. r- r $\-e o O��ve (t-ISoSo
City/State/Zip: C 'c onCI cJ\ O 2_e,B 1 Phone:
2008 Residential Compliance Forms March 2010
OWNER College Mesa Co. DATE 9/21/55
JOB ADDRESS 1332 Watson Ave BUILDING PERMIT NO. 1901 ,
GENERAL CONTRACTOR Hale CO. VALUE $ 8.000.00
•
L' - 116 BLOCK TRACT 2341
' GROUP I TYPE V ZONE Nil FIRE DISTRICT #1925
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Footing Trench £-14. /2- 3 .0
Foundation Forms and Grade to GaraggO /e8-s4 f
Rough Framing .Th2 1d -M I
Plumbing,Rough to Slab 4- ZO^ �
Plumbing, Rough Complete )144 *" .i/G_.A a-n - , an ,4--7-s 6 -p e2 / C//
Temporary Pole U (/
Wiring,Rough, -' '- ) -t4-,St y,,..- 0,4-J. i-7CG-Cl /9v2 /_—
Heating, - •u
Heati • igf l, _ , i , Al- 7-SJ3/S�
.,Sewe , nark Sewer,St. 4 t"-,oL71/ ed //-,7 7 a c5- SS-9.5-e--
Septic an •r -ss•oo fr.
L ing, I ' If I2., •ut)C Cs' a 2.-A-at
i Bering e,E/E.-- 3 -c(-A-/
Plumbing,Final,Fixtures Complete L
Plumbing,Final Gas Test 544%,-( C ..� / V 'a`
� ' Et ' ,
Wiring, Final 4i4/3 5,1(f L
Occupancy 17- A 5-'1/-71
l:`€ ,,,`)1n1 _T-T1cnn1_cc
costa Mesa Building Department• 111 EAST 20th STREET 1925 APPLICATION FOR PERMIT
.�- ,`�' BUILD 1 N G il
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN 1 Receipt No. I I�
Building
Address 1332 Watson Ave. . ig
Costa Mesa, California Receiv by 1 Date Recd. 1 Date Issued
SEP 1 91955 1I-2-.,--4/
Nearest College St.
Cross St. gBuilding
Address
owner College Mesa Company Costa Mesa, California
Mall
Address 8002 Central Ave. . Nearest
Garden Grove Tei'Le.9-2158 Cross St.
City No. Zone/f� I No.of I Type. / Group f
Architect or Lie. �F.• Plans (/ l-
Engineer Davis & Quigley No. C-1790 Approved
Address 43 Malaga Cove Plaza,Palos Verde by Date
- City tic. CORRECTIONS
tractor The Hale Company No. 3422
Address 8002 Central Ave. ,Garden Grove
LegalLot I
Description I No. 146 I Block I Tract 2341
e2. .---,.\ i rn
(Attach Metes and Bounds) SIJ (� '� 11 ��
No.of Bldgs I �- 11 i ,
Size of Lot 7384 I Nowon Lot None 1 II 1 li
Use of I No.of I No.of -tom �� a
Existing Bldg. Families Rooms
Setback Line from Rear Yard 40' SEP '�' 1955
Center of Street 50' Side Yard 6' j
DESCRIPTION OF WORK �9y n r
New I X I Alteration I I Addition I ��' OF
COQ�`1 �d�t�/y
Repair I I Moving I I Demolish I
Building No.of
Size 1181 Rooms 5 Stories 1
r 'rior Wali I Roof —
:ring Stucco Covering Rock APPROVALS
_
Use o
Building Single family duelling rri ill Forms,Materials,
attached garage. Under-Pinning
Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application
and state that the above is cotiec.t and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating
building construction. Lath. Ext.
Signature of TH HALE COMPA
Permittee Plaster,Int.
Authorized Agt. n. Plaster,Ext
SILVIA LIMNER
Valuation Permit Fee $ !Ji 0 Masonry Reinforced
Oxy O Q Plan Check $ .3 Bond Beam
$ V, O Total
Fee $ cQJ FINAL
FORM 204 S-BP 2M 6-55
•
•
;m
C Y
a o
L. SEP 21-55neer COSTA
61 9,
a 0 o C.`.itic23��
a ,
•
•
•
•
•
Street 1
PLOT PLAN
Show location and distances from •
property line and between buildings .
`41'!JOB ADDRESS 1332 Watson Ave. BUILDING PERMIT NO. 39583
GENERAL CONTRACTOR welter w. sant Const.Co.DESCRIPTIONofWORK Add Fam.Rm. & Bedrm.
AP No. 141-Ojb-12 LOT TRACT FIRE ZONE VALUE $9,750.00
1 ,,`,4CTIONS Signature Date TYPE V GROUP I ZONE R1
Td...;',.
, SUBCONTRACTOR PERMITS ISS ED
GAS Date I Number Signature
WATER1 Plumbing
ROUGH PLUMBING R•D v--:211-1S Ste , "nt a-tQ-7r ob 731-/
PROP. SWR. LINE Q HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS ��L' [�
ROUGH HEATING AND AIR CONDITIONING I`�..C> 9 rv7S
TEMPORARY SERVICE OR POLE 1
UNDERGROUND ❑ POWER ❑
ROUGH WIRING h�"a „ ��� �aT<MHeating on fYent.
TRENCHES { i'I' FORMS STEEL REINF. 0 y1 JTTss t/Y]] � n+'-fQr/4✓ Si/
FLOOR SYSTEM
BONO BEAM n STEEL REINFORCE n
SHEATHING . # dP"2 )
FRAME AND FLASHING / ter C 9_
LATHING - IN OUT rf� Add eV- am-
PLASTER, BROWN COAT .Atp ;`22( ----7‘151
STRUCTURAL, FINAL ,// ��—Elect is
HF S. VENT., REFRIG. AND A.C., FINAL Q. O ',MC {.F�q{ i.a) 07-10 7.St,3er6/D'�
PLS ,ING, FINAL AND GAS TEST n .jK'T tV —2.771 •
' ELECTRIC, FINAL ill-2 1-H)} e Qi - '{•7] '
BUILDING. FINAL +� 11"3-75"
-:i
3958.3F4 I io'7s"00 237 ¢ 66.65
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
I
• AP LI ATION FOR BUILDING PERMIT
For Applicant to Fill in Completely R SHV DATE RECEIVED DATE ISSUED
BUILDING ` A
ADDRESS/332 C14- -at) ke. o— zi
// I�kl % - �•
OWNER wr %L(,yG�CLiC/ A.P. NO. �O ' 1� �J•,t3
MAIL BUILDING
32 ///� o,v Aye--¢� ADDRESS (�(f ! N
Z ADDRESS �33 G{/0. (L.dr�/
w W TEL TRACT Vat+, LOT Iqt
p BLOCK U CITY NO.n/4'2977
- I- CONSTRUCTION n _ O NEW Q
t�rW D<. ALTER RE'AIR MOVING nFMDI!SH
0 u LENDER
• CO
D
J to BRANCH OWNEE�R�j/OSJ s/,//�,�/et s/yS�_, eie/'J�
o ARCHITECT - TEL. US ha C7N EA i"✓Gi 'V✓�LU$ / �/^n O"��
OR ENGINEER NO (f
U FIRE
W CC ADDRESS '� ,(J ZONE VPf GROUP _ /CL Ly /J
J O CONTRACTOR � ,Lf 1.61)2444/rm. J 6 BY
PROVED DATE ��,�'�/�j/
CO 111-�`/J��^-'T
J Ir ADDRESS 75"7 CU ,F Q✓
W W � �/ TEL ZO NO.OF �j USE OF NEWt ^c M
ZF2- CITY � '-"� No.633-32V l PLANS C- BUILDING AZ:9>
W U STATE CITY YARDS APPROVED YARDS APPROVED
to 2 LIC.NO. 2 2 y 8 09 6-i LIC. NO. MAIN BUILDING ACCESSORY BUILDING
D U SIZE NO.OF BLDGS. (FROM C/L STREET)
OF LOT 6Sr6s/ ,x �yy.6y. II NOW ON LOT / FRONT 52FT. t. FT.
USE OF
EXISTING BLDG. ✓/� I f - R.SIDE • •TT. FT.
I-
Z NIZE OF EW BLDG.ps /s��ez� L -�rROOMF
S 3-. STORIES / L.SIDE .5–FT. I FT.
C EXTERIOR WALLS-tea ROOF
ti COVERING COVERING e0-C-4.... REAR A-77
FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0-
�.f�� D p�/ /200,-- MAIN BLDCS. ACCESS BLOCS. c,.
O r'` !/ P+ VAC URP.#t DATE
APPROVED
1/4,41
~ /Hl_1 r� s APPROVEDp[�J�,/ DATE ZSTA �7
N ��1S��III ` Y `J//
t~.) I hereby acknowledge that I have read this application and state !
that the above information is correct and agree to comply vdth ((I
CC all laws regulating building construction, and I shall not employ -f
i_ any person in violation of the workman's compensation laws of `
to the State of California. W
zI hereby certify that 'I am properly licensed as a contractor under SQ. FT. O
the State of California Business and Professions Code, Divisic:n 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR b
Chapter 9, and that 'such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; 2
am exempt from the( provisions of the State of California�` BUS j //�,J
and Professions Co ay DIvislo 3, apter/9 0=�J ' VALUATION 441
i/ tel
PERMIT FEE $ {Y'
Signature of �� q �1 m
Permittee I $ 753 r PLAN CHECK $ ONO'c E
9o
Authorized Agent u_
TOTAL FEE $ (J
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. �(1 i�
CITY OF COSTA MESA CONSTRUCTION PERMIT PERfyII i NO. TRACT NO. LOT NO. UNIT NO. \741\UNC 7032 6/27/64 5.0'. IL
Project Address -3 3 R %.J3A-tn!� � q E `+ H \
Applicant's Mailing Address 'trio �1t:W lA-n-.1P1 TYPE OF CONSTRUCTION El NEW LI ADD Li ALTERATION REPAIR '
N.xT C Phone ldu�-��/�O ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone
Owner's Name /� DESCRIPTION OF WORK/USE OF BLDG. - '
3
Address 1 '" t' 4
N •`v` S Main Building: Accessory Building:
E Z
Arch/Eng. -- License No. TYPE OF PERMIT E❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front 0
Address , t,,_ l\ ❑ TENANT t , LECTRICAL ❑ PLUMBING ❑ MECHANICAL B RearA • N
HUA� �Ufl2C \ �ht� Phone Ida k +� ❑ -OTHER • C Ri . - •
I
L_/�/ Contractor's Name /��tght N
Address(mailing) Z•Z7(p‘-did• LQOI n Arni.6.1A--. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left
t CONSTRUCTION TYPE VALUATION $ • S G
cP City License No. �1 ' , ZONE GRADING CU.YDS. ACRESE
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req,/Provided
1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: nn �^ rn� Planning Notes: M
with section 7000) of Division 3 of t u ess and Professions Code,and //��Il `l F-.l Vat �0 �9- COO 8Tu Af
my license is in II force and effect. !!!! •
• T
Licens- Class - I '�,� po. Z S.
Date .--• l^ig- Signature ��t! AID `��' PLUMBING • FEES `
WORKERS'COMPENSATION •EC ARATION '• Bar Sink Showers
I hereby affirm that I have a certificate of consen to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation.Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
3800, Lab. C.) -
Automatic Washer Transformer ❑ 15-50 KW
-
Policy No. 5S-(e Company ir - V Backflow Irrigation Sewer Cap Construction Pole Sub. • ❑ 50+ KW
Certified copy is hereby furnished.
rtifiedQ� copyets_(iled with the city ' og,isi.1 /t ons.: , Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date p-, Applicant IL
EXEMPTION FROM WORKERS'C MP SATION • LARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if th permit is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
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 ; Drinking Fountains • Solar Tank ; Fan •
Motors El 0-1 HPI'/:-6 Z
Workers' Compensation Laws of California. —
Date Signature Floor Drains, Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP El 16-15+ •
NOTICE: If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY •
Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range
Lender's Name-
•
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION' -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories -
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair. P-Trap
any structure, prior to its issuance, also requires the applicant for such permit Generator 00-5 KW ❑5-15 KW Trash Compactor
.to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains '
the Contractor's License Law(Chapter 9(commencing with Section 7000)of - •. ..
Division 3 of the Business and Professions Code) or that he/she is exempt ,
'herefrom and the basis for the alleged exemption. Any violation of Section
'031.5 by any applicant for a permit subjects the applicant to a civil •
Uenalty of not more than five hundred dollars($500). ,
.1, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee ' $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I ❑
sale. If, however, the building or improvement is sold within one year of coin- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground wlding Approved By Date
Ove for the purpose of sale). v %24/3
/f, /`� �Z�
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By L/3 Date
tractors to construct the project (Section 7044,Business and Professions Code: •
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 110-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con- - -
tractor(s) license pursuant to the Contractor's License Law). I am aware that ti t' I R L BUILDING PERMIT $ SMIP $
fto Exhaust System ❑ Multiple❑ System Repair/Alt a ion
proof o their Worker's Compensation insurance should be provided this me. I(}(.UI H)Jlttf, II?CFCCtien PLAN CHECK $ PERMIT
❑ am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting ENERGY P.C. $
❑0100,000 BTU ❑100,000 BTL O0t8 _ Sig ---------
E
- PLAN CHECK 25% $
I hereby certify that I have read thismapplication all cityytl state that the above ELECTRICAL Sc% GRADING $
information is correct. ogre to comply with all and county ordinances
and state laws r• .ti to br�ding onstructl.n, and hereby authorize repre-
sentatives of t I c to�y to pon t•- ...eve-mentioned property for
inspectio p ••• / 43.-421.-8C1
2 8C i'' MECHANICAL $ TOTAL FEE $
Signature /a . ,/a Date r1�r r'T
Drivers' i e e or 55#�� Gr �' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
•
CMF 0865-46,rev.4/84 White-Building;Canary Applicant;Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL SPA
APPROVALS Permit# 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 Conduit'Utility-Undrgrnd. 54. Forms
4. Electrical Conduit:Undrgrnd. 55. Electrical Bonding
•
5. Steel Reinforcement , 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. - • 57. APPROVAL TO COVER-GUNITE
7 Footings 58. Electrical Conduit-Undrgrnd. .
8. Foundation .- - 59. Gas Pipe, 0 Undrgrnd., Test 6 �•
9:Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System , ' 61. APPROVAL TO DECK
11. Property Sewer Line'& House Connection . 62. Backwash & Receptor-Final
12. Sewer Cap • 63. Heater & Vent-Final
•
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - 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
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
32. Electrical Power Meter-Final' 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
•
35. Final Gas Pipe-Test
36. Hood or Canopy
37.,,Final Factory Fireplace
.38.,Final Plumbing •
'-39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
•
42. Backflow Preventers ,
43. Backflow.Irrigation
44. .Landscape Irrigation System tk
4
45. Sound Attenuation
46. Handicap Regulations Incomplete IIisoertirsnc
47. FINAL STRUCTURE & BUILDING
data G/ �/!Sig ciatas
48. Special Requirements Completed
49. Electric Release to Edison • • .h
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY •
No. Date