HomeMy WebLinkAbout2330 VANGUARD WAY - Building Permits (J203) ADDRESS OFBMLDD1O: 2330 VANGUARD WY i um:: J 203 CITY OF COSTA MESA - BUILDING PERMIT - g— nOrR
CWNEWSNAMEDIwavN:GEORGE & DOROTHEA t ! PERM NO: P 08770000
ADDREss:GOULDSMITH
2330 VANGUARD WAY J203 PERMIT NO: P 087700 PLAN CHECK NO: N GOVT: N SUPP : N
:OSTA MESA, CA 92626-6584 ( 714 ) 966-8368
APPL.MARINO ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
•
ARCHITECT ORE/MEER: UC.NO.: JOB DESCRIPTION : INSTALL NEW GAS WATER HEATER SQ FT:
NICK.OR ENG.'S ADDRESS: WIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
cGNmAcroRSNAME RANCHO ROOTER ( 909 ) 989-1980
CWm1CTORS AMINO 9360 BASELINE COMMENTS : REPLACEMENT OF WATER HEATER ONLY
AooREss:ALTA LOMA CA UCND.: 689936 +E******+E4*RE*+r*** *Rt**********it****itit***********RE***Rea*+e***#+Eit****+t*********+E*+E**
91701 WIT: C Z ONING REQUIREMENTS
UCENSED CONTRACTORS DECLARATION:I hereby Wim rider penal/of Perjury that I em licer®d under prwblws d Chaplet 9 SETBACKS
(commencing with Section 7000)d Division 3 d the Bovis end Professions Code,and my license le in full force and Wed.
CITY UC.No.: UC.CLASS:C-36 ucN0 689936 EXP: MAIN BUILDING ACCESSORY BUILDING
1(J FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Dm.: y-/y 9r co. /C) FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
OWNER BUILDER DECLARATION:I hereby an,under Penalty Of Orin that I am mama ham the CatWos Lienee Law for the
• ldiowic wean(Sedley 7031.5 Bneims and Professions Code:Am;pry Cr owdy win wares•permit to construct,alter,'vnprore, PARKING RE P RGV: PARCEL: 93865186 INE: REF NO:
demolish.or rapes any Mmddm issuance.e,prior tot abo reqdWficant
rss the aIce such pend to Bee signed statement that he or she Q
is limreed pursuant to the provision.d be Contractors License Law(Chapter 9(commixing with Section 7000)of Divmon 3 d the PLANNING NOTES>
Business end Prolenboe Codej a that he or she is exempt therefrom and the bees for the alleged exempla,My violation of Section >
7031.5 by any applicant for a permit aiDeds the appkent toe dvs penalty of not more then the hundred dollars(SmOD. ***********************************************3E*******************************
❑ I,es owner of the property or my employees brith wages as Mei sofa compensation.wil do the work,and the Pructure is not intended DEVELOPMENT SERV R V I CES"---S'"-• R E U I R E M E N T S
or offered for 04
sale(Section 74,Business and Professions Code:The Connectors es
o s Lice se law does netapply loan owner of properly Q
who builds or improves thereon,and who does such work hdnses ea herself a through his a her own employees,provided'hal such _.S
Improementa are nd Wended aWered for salt S,however,the&t*"inpmwnetl S soil elhbosYea'd mmpletm,te ZONING APPROVED BY DATE:
owner-Wader will en have the burden of proving he a she did not build or improfor the propose d sale).
❑ I,as owner of the progeny,an,exduedy connecting win keened contractors to cwmud the poled(Section 7044.Business and 7
pweasiorecode:Thecwamdoe License Lawsons not appy a en owner erl
propy who maw aamw,nlherem and who BUILDING APPROVED BY : DATE:
contracts for such projects with a canada(s)!cased p rsurd to the Contractors Live Law). ±4 ct �*
❑ I am exempt under Section: B.AP.C..for tbroaon: APPLICATION ISSUED BY: y t� el. f. _ DATE:
Omer Dane: Oer: ********************** . 41 *********** * * ***
I do hereby candy tat l eaware d end understand the requirements of CaMaria Health and SafetySm
ions Code Siau Pcalm,P55-T,and LEGALIZATION;N F E E S U M R Y STRUCTURAL SEGMENT:N
m
25534,and that I or any future building occupant will/wD not(dcb ono)need to comply well said date codes and the requirements ler
apermn for mnemdion or moddwion from theAirWaaneennem Distrd.Residemid cmmnaimapplmws areexanglmmmeme • BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provision.. PERMIT 11 . 00
Done: Applicant: 25% SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby Store under penally of perjury one of the following dedarelbns: PLAN
ur
ISSUE FEE 22 . 00
CI. lheeand Ml meanie',• of the consent m••°pens isSue•"'`ompwdion.asprovided for by Beth°•3700 of the Labor BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code.tor the performance w rk for which this permit b issued.
a —TOTALS 11 . 00 22 . 00 0 . 00 33 . 00 33 . 00 . 00
work for whin this permit is Issued.My warkas'arnpenW ion insurance comer and policy number are:
cm*: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 33 . 00 OVER/SHORT: . 00
Policy Number: ) 409 /'Ay-9 / 07/01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(]his section need not be complete(l the panne s for as Minded doors MOO)or les.) 33 . 00
❑ I certify that in the performance d the work for which this permit b issued,I del not employ and person in any manner so as to
become*Aso to rhe worker'compensation laws Of CeMarna.and same Net i I 'dull become nmled to the wakes' *******************************************************************************
compensation provisions d Section 3700 d the Labor Code.I shell?cobweb comply with tnm.provisions. I N D I V I D U A L F E E B R E A K D O W N
Date: Y—i 11-77-- Appran:• _
blaming:Aleut rosecure workers'compensedon vantage!SUOinve4 and shall subject an employer toarrdrer penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil firms tv ro ane hundred thousand dollars(Ifa4000),in.dpdon to the cost of compensation,dances by prodded to,In
Section 3rosaynw
eL.ep,ca ,Dd«.,(.ne.Dram. .r..e PLU 1 WATER HEATER AND/OR VENT 11 . 00 11 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under panty of perjury that them is a mrwndion lendag agency ler the END OF FEES
pedamence of the wont ler Mich this forme is bawd(Section 3047,at C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have reed this application and Mare Nal the above information is coned.I 070010 comply wish an thy and county ordinances
and stale laws relating to building mMrWion and hereby authorize representatives of this ray to enter upon the above-marts oned properly
for inspection purpose'.
DAN I EL ROE 04-14-1998/83:11 03/S33.CO
Print Name cf /�%L(`kyr PERMITo
A) Date: 087700
Signature of Owmr/ApsWAppimN/Comrmor
(5151.48.WP) White-Ouildig A Slay:Green-Rle:Canny-ApPfeam:Pink-Revenue:Oddenmd-Msemr
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
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, Cl 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
tor 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 PREY. 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 -t
38. Final Plumbing I� p'
�
39. Water Service-Final
40. Gas Service-Final .
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING -
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA • PERMIT NO. TRACT NO. LOT NO. BLDG.NO.
CONSTRUCTION PERMIT -7°33 0 11481 I Ji - 03 17 ' /
Applicant's Mailing Address a S IS- 1: ' a$ TYPE OF CONSTRUCTION ® L
NEW U ADD U ALTERATION J REPAIR '
Project Address 7110 Vanguard Way •11-203 0 CONVERSION 0 DEMOLISH 0 OTHER
Owners Name Newport Landing. Ltd. Phone 274-0953 DESCRIPTION OF WORK Cnnrlrimini itm / Tyre R •
��{{ s�,•�' ZONING REGULATIONS
P.O.
Address Box 10841, Beverly H111 S.. CA 90213 TYPE OF PERMIT LA GRADING FOUNDATION Usl STRUCTURAL A.p,qY• Li) j -)5)— p)„ ZONE 125 •
•
Arch/Eng• Clark & SI'IC(1r1C L- No. C.-2578 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL DING
11969 San Vicente B . L.A. 90049 PLNc.REF. W _83- 110 T')/(/ �n� I cT
Address ❑ 'OTHER TO BUILDING
Contractor's Name Phone PROJECT DESCRIPTION SQ. FT, 1170 - OCCUPANCY R-1
PROPERTY LINE REAR YARD(TO P/U
Address(mailing) CON STRUCTION TYPF V - 1 hr. VALUATIONS 61,500 . LEFT SIDE YARD (0'(,) b )� GHTSIDEYARD ' ' C) b)�
ZONE R-3 GRADING CU.YDS.S1"LP ACRES PKG.SPACE REO. L: PROVIDED ,�
License No. __ - - r .J
LICENSED CONTRACTOR DECLARATION Remarks: Building j - Unit 203/Type p STREET WIDTH �/��r�I PARK FEE$ grj�, S)
I hereby affirm that I am licensed under provisions of Charter 9 (commencing -Y "SObIJ �in ��a.Cae�L Is]:�(uini:d.�;y 1p
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS:
my license is In full force and effect.
License Class License No. PLUMBING
I- -e Signature
IKERS'COMPENSATION DECLARATION Bar Sink Sewer Cap ELECTRICAL
- -
,reby affirm that I have a certificate of consent to self-Insure or a certificateBackflow Preventer Sewer Connection Automatic Washer Meter Dover 100 amps
of Workers' Compensation insurance, or a certified copy thereof (Section - -
3800, Lab. C.) Backflow Irrigation SolarCollectors Construction Pole Sub Panel
Policy No. Company _ '- _- Cooking Unit Sub Pole
ECertified copy is hereby furnished. Bathtubs Solar Piping
Certified copy is filed with the city Building Division. - Dishwasher Motors 00-1 HP 01x-8
Date Applicant Clarifiers • Solar Tank .
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher SwimmingPool w/Sp Dryers ❑Gas ❑Electric Inc.Solar ❑9-15 HP ❑16-15+
(This section need not be completed if the permit is for one hundred($100)or
less). Fan Microwave
I certify that in the performance of the work for which this permit is Issued I Drinking Fountains Urinal
shall not employ any person In any manner so as to become subject to the F.A.U. Pole Light
•
' Workers' Compensation Laws of California. Floor Drains Water
Date Signature Fixtures
NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Hec Range
. Workers' Compensation provisions of the Labor Code, you must forthwith Device Boxes
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets ter Servs Sign
CONSTRUCTION LENDING AGENCY Outlets
I hereby affirm that there Is a construction lending agency for the performance interceptors Standing Sections '
of the work for which this permit is issued (Section 3097 Civ. C.) /—
Lender's Name Kitchen Sink •� `100.„.............),...„,
Switches • Trash Compactor
Lender's Address /�'i .t1 —Garbage Disposal
OWNER BUILDER DECLARATION • Lavatories ^ CCC������ i. 9 PI hereby offirm that I am exempt from the Contractor's License Law for the - 'P-TreGenerator ❑0-5 KW ❑5-15 KW
following reason (Section 7031.5 Business and Professional Code: Any city or p _
county which requires a permit to construct,alter Improve,demolish or repair S\C' Transformer ❑75.50 KWan structure, prior to its Issuance, also requires the applicant for such permit Roof_Drains° ile a signed statement that he/she is licensed pursuant to the provisions of • - ' ❑50+KW„-...,i.,,,,
' ontractor's License Law(Chapter 9(commencing with Section 7000)of �• Reinspection Fee $15Ion 3 of the Business and Professions Code) or that he/she is exempt Showers <�� \ Reinspection Fee $15
J
•eie'refrom and the basis for the alleged exemption. Any violation of Section ' - <C Meter ❑up to 100 amps ,Issue Fee $ 3
' 7031.5 by any applicant for a'permit subjects the applicant to a civil t�` - v� h _
' enalty of not more than five hundred dollars($500). - Service Sink O(` Issue Fee $ 3 Zoning Approved By w Date jp'�-'���--G/d-�
C 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 I , MECHANICAL Application Approved By (N`7/N L•J'a' nate 7.2-..a., '9-1 •
' for sale:(Sec(ion 7044, Business and Professional- Code: The Contractor's -. - - - - - - • • - - ------ - - - �/
License Law does not apply to an owner of a property who builds or improves Boiler Refrigeration System
thereon, and who does such work himself/herself or through his or her own - Application Issued By - Date
employees, provided that such Improvements are not intended or offered for Duct-Under Ground ❑0.100,000 BTU 0100,000 BTU
sale- If, however, the building or Improvement is sold within ono year of com- SUMMARY OF FEES
pi on, the owner will have the burden of proving he/she did not build or Im- �r
ve for the purpose of,sale). 4 Duct-Structural System Repair/Alteration BUILDING PERMIT $ 3/9^O' SMTP $ ^'7"'
I,as owner of the property,am exclusively contracting with licensed con-
tra ors to construct the project(Section 7044,.Business and Professions Code: Duct-Ventilating PLAN CHECK $ PERMIT • '
The Contractor's License Law does not apply to an owner of property who ISSUANCE $
builds or Improves thereon,and who contracts for such projects with a con . Exhaust System 0 Multiple 0 PLUMBING $ I '
tractor(s)license pursuant to the Contractor's License Law). GRADING $
❑ 1 am exempt under Section B.6 P.C.f•r this reason Firepl/Fact.Bit. ICBO aW •
PLAN CHECK $
vi �- ELECTRICAL $ $
Date ialicaLi Owner /���Q�.'L� a Heating System& Ducting MICROFILM $
I-her-by .rtlfy ghat I have read- is application and state t --t the above ❑O-100,000 BTU 0100,000 BTL - - PLAN CHECK $
Information is correct. I agree to comply with all city and county ordinances - TOTAL FEE $
and'state laws relating to building con truction,and hereby authorize repro- MECHANICAL $
sentatives of thi city.to enter up• t - ab•ve-mentioned Pr pert for Hood or Type I 0 -
Inspection Dap! '- / ' Canopy Type iI 0 Reinspection Fee $15 PIAN CHECK' $ LESS
SI nature ' _ d ADVANCED PC $
Signature i'.� - de Dat
Drivers' License or 55 sr Registers Issue Fee $ 3 3j
FINAL FEE $ 3.-���
CMF 0865-46 rev.12/82 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod -Assessor
i_ nCONSTRUCTION:AND;PCANNING. . ' .POr SPA _
C' • - - ;'Date c ,inspector - - - - - - Date Inspector
> '-APPROVALS ` Permit#- '` APPROVALS- Permit# - -
rL .. - - - - - _ , .-
'- 1 Temporary Electrical Service or Pole ' - ' 52: Pool & Equipment Location - - ' .
iv 2: Soil Pipe-Undrgrnd.' ' C' _ " r ( SteelReinforcement 53(.. Reinforc '
3' Electrical Conduit Utility-Undrgrnd. 54.:Forms . , . . •
r,. 4, Electrical Conduit-Undrgrnd' : • 55.. Electrical-Bonding
5: Steel Reinforcement " _ _ 56. Rough Plumbing & Pressure Test
6: 'Electrical LIFER Grnd. r. .,,„- ' - ' 57:-APPROVALTO COVE R-GUNITE-
7. Footings ' - - 58. Electrical-Conduit-Undrernd. - - -
8. Foundation I I • • - • ' • F '59. Gas Pipe, 0 Undrgrnd., Test' '
9. Water Pipe-Undrg'nd. , • . 60. Backwash;Lines,P•Trap, O'Undrgrnd. < •
10. Structural Floor System : .61. APPROVAL TO-DECK - . . •
11. Property Sewer Line &.1-louse Connection, _ 62. Backwash & Receptor-Final _
•
12. Sewer Cap ; _ '63. Heater &Vent-Final
13. Roof Drains ' • ' 64. Plumbing System.- Final . ' - _
e 14. Rough Plumbing ' ' - - 65. Electrical-Final. - 2 - - ' •
' 15. Rough ElectricaPConduit , - - - ; f . 66.-Solar System-Final , •
r 16. Rough-Electric Wiring- - i - - - �c < 67. Fencing& Access Approval - - - - - - - - , -
c ,'� 17. ;Rough Wiring Sign; - . ' , - - 68.. APPROVED FOR PLASTERING -
18. :Rough Electrical T Bar Ceiling, . - : ' j 69. POOL/SPA SYSTEMS.FINAL ' '
F
19.,,Rough Heating&Air Conditioning - - FI&E'DEPT:-REQUIREMENT.
20. ,Rough'Factory Fireplace' ' I - APPRO)'ALS 4Permit# -
21: Ducts,•in Strugturer• • : ' I 70.1 Jllndergroupd Hydro
x`22. ;Ducts, Ventilating i , - j 711,ProduatPiping 0GA/ 0 Oil '
J23. Gas Pipe-Rough& Test ` : I 72. Unde• r
1'. J23. Flus ' -14
X24. Roof Framing . ; ' 73 Undergrnd.Store Tank 0 Gas 0 Oil
5- < ,
25. Roof Sheathing ' _ i 'J4. Overhead Hytdeo
.."-26. T-Bar Ceiling (Structural) & Monocoat " ' it=.f.75. Dry Chemical - ,
7
" •X27. Frame and Flashing , J 1?.74i
Dry Standpipe . -
28. L'athing& Siding ", '1 '`1"l-77. FIXEQ SYSTEM FINAL
29. ,Insulation I • ! 1'78. FIREJPREV. FINAL '
30. Drywall Nailing >2 ' ' j
I, • . ' Ms:,�i
: _ '
;31 .;;Plaster Brown Coat i , • , I i
r'32. Electrical.Power Meter-Final l , I ' '
• 33. 'Final Electric I • , ' r
34. Final Heating&jAir d Cdnitioning -
35. Final Gas:Pipe�Test ,, `. - .. .
36. Hood or Canopy_ - - -
37. Final Factory Fireplace , r1
r
38. Final Plumbing ) ; ' -
39. Water Service-Final • ' - "
ti , - .
40. Gas Service-Final `
41. Solar Domestic-Final ' - ,.
42. Backfl w Preventer y ' I w • _ _ , - , ,
43. Backflow Irrigation I
44. Landscape Irrigation System-- ' • -
45. Sound,Attenuation - '. ` '
46. Handicap,Regulations ! - I '
;
47. FINAL STRUCTURE& BUILDING ; ' . • '
48. Special Requirements Completed - .' - -
49. Electric Release to Edison I _ - "
50. Gas Release to Southern California Gas Co I : , ' i , •
51. CERTIFICATE OF OCCUPANCY - _ 1. ,
No I' Date i , - - _,
' . - _ - -' -i -- -.- - - -
City of Costa Mesa
Development Services Department CERTIFICATE OF OCCUPANCY No. 001.586
Building Safety Division
P.O.Box 1200
Costa Mesa,California
The Building located at 711(1 Panrntarrl Wax/ .7_9(11
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group D...1 • Occupancy.
Use of Building r.,.,Ar nin4,,m
Legal Description 41 GLl a1_nf.
(See reverse side for Metes and Bounds)
Building Permit No G16876 Electrical Permit No16876 Plumbing Permit No. G16876
Mechanical Permit No. al FR7F Number of apartments ll- and/or guest rooms
ISSUED TO: Building Official `'<L4./.l .d` -
Newport Tan im Limited
P O Box 10843 by
Beverly Bills. CA 90213 L/ i /y r1
Date ,
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 le) U.B.C.
CMF 1015-46 rev. 1/83 White-Owner;Canary.Numerical File;Pink-Bldg.Permit File
Pr
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT NO. TRA T LOT Np. BLDG.NO. 5719 1/15/1h p 7.b? ' iJ
•
CONSTRUCTION PERMIT c OS1 (o (/�/ � / 3' O3
Pro/eel-Address 0 :. S : 1/ a : c _ . TYPE OF CONSTRUCTION NEW ADD LJ ALTERATION REPAIR
Applicant's Mailing Address • .• C•. I • i'i►E . •I - ❑ CONVERSION El DEM ISH �❑_1 OTHER /+ �p �z- A.P.'I' y/ 9_ J 5l-eJ- , Zone �-- 7
' • s04 _ r DESCRIPTION OF WORK _SSCL�+I/c/ L7"�l'a-�s�s"� �'
Owner's Name L &R; L.,. .b .i. •. •h'on`e �Z� �3� S Main Building: Accessory Building: ZZ
Address • f� E
I TYPE OF PERMIT El FOUNDATION1gIp STRUCTURAL T Front ntr-RcAP N
r' Arch/Eng. CLARK —HsORiCK License Nu. / C. 50 WI 0 TENANT ® ELECTRICAL ® PLUMBING IN MECHANICAL B Rear �T7�qqqq L �/J I
Address 11969 SAM UICE&JTF CSL•/ L A 9nogq ❑OTHER A I�'//F1C 17P N
! Contractor's Name PRUL�1F7R)CK rp�Pha YJ pp O�^TY1 PROJECT DESCRIPTION SQ.,FT. s, ____ OCCUPANCCYT R-1/M.1 K Right L1.,..., n nf0,1,-.--3T—i,l tax'.T _ R
Address(mailing) II 83.3.9.-Th
��S]2 -I A- GRAN)C�E PL., L•1T CJQuar, CON ST RUCTION TYPE r IV VALUATION$ 69,i 4- $ Left 26 /7 P PS/ ..17.,1,374.0-
/, 74. E
00 City License No. It 33 /R ZONE GRADING CU. ACRES Ping. Ref.# at- 5-6 g Park.Fees $ /23_7- 3g O
�
U
LICENSED CONTRACTOR DECLARATION Remarks: rte" C 5 07 i J�5L Parking Req./Provided 2- a-00I hereby affirm that I 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: a/ •
my license is in full force and effect. '
I '.;Jcense Class �" c� • PLUMBING FEES Planning Notes: __ ..o.wss+rt•P( E
i`'9ate - ' - �' Signature �J �. HD LU CL°1i J:Lld1.L RL,u_cw-raa+s.a. N
•
WORKERS'COMPENSATION DECLARATION Bar Sink Showers - T
I hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer . Service Sink • . S
of Workers' Compensation Insurance, or a certified copy thereof (Section _
3800, Lab. C.) 1 O p SIEVE
Backflow Irrigation Sewer Cap - _ - - ELECTRICAL ' FEES
Policy No. S67 138-All Company Jl/liECOMPTNS-R11)I _ " 1
❑ Certified copy is hereby furnished. a. Bathtubs Sewer Connection C4-C .I Automatic Washer ' , Transformer 0 15-50 KW I-
Q(j
Certified ggpy Wiled with the city ,/�/f9Jg pJ+ ,�// I. r-O
Date II- 1'1- "ti Applicant I�7�lV C/r/ Clarifiers Solar Collectors .. Construction Pole Sub. ❑ 50+KW _
EXEMPTION FROM ORKERS'COMPENSATION DECLARATI - - -(This section need not be completed if the permit is for one hundred($100) or / Dishwasher / Solar Piping�D06/P ,tj 9 5 Cd Cooking Unit ' Meter' ,('up to 100-amps • ,5"- CO
less). , 'Drinking Fountains '
I certify that in the performance of the work for which this permit is Issued I Solar Tank L �1, Dishwasher �•• Meter Dover 100 amps t OCA
shall not employ any person in any manner so as to become subject to the ,
Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa -
I Dryers keels '❑Electric 1 Sub Panel Co 00
Date Signature - l .^
NOTICE:If,after making this declaration, you should become subject to the Floor Sinks Urinal . 3 Fan i Motors 00-1 HP 01%-8 _ c-( cC
Workers' Compensation provisions Of the Labor Code, you must forthwith n _
comply with such provisions or this permit shall be deemed revoked. / Gas Service . ..5- aa;
Outlets. Water Closet (.p D3 l F.A.U. Inc.Solar 09.15 HP 016-15+ ( Y)
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance Interceptors ./ Water Heater Z co 12 Fixtures Microwave a s(Q
of the work forUlylfich_(hjstpSfr/1}1J; ISs0erL 15ee1iy A097_Civ. C.)
Lender's Name I�rJ�i'F"RR FMI E�l1�Jt�-J�fc�' RfJF(('�(�{j l:(J Kitchen Sink Water Service t�-p(� ' Device Boxes •
Pole Light '
Lender's Address q7 q LIN)CO A) U ILLA E 1b`p,JSYQ.Sof
OWNER BUILDER DECLARATION SACRAfIEAfto, C'a-.`•1D ai Lavatories 6..1, , // MAelf�,uc b C a Outlets Range CO
I hereby affirm that I am exempt from the Cdntractor's License Law -7 or the P-Trap �1.
following reason (Section 7031.5 Business and Professional Code: Any city or • IS Switches Sign '3 00
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 Roof Drains Garbage Disposal Standing Sections • I DO
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
Division, 3 of the Business and Professions Code) or that he/she Is exempt p
therefrom and the basis for the alleged exemption. Any violation of Section '(�, ,I .(��t-•
7031.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee I $'3 Z 4"T'*4 - a- Z0'
'geenaity of not more than five hundred dollars($500). pe $25- Issue FeeY
LJ I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Flee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - ------ - - - ------- ------------ •-- - - - PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type /✓y�� A•
thereon, and who does such work himself/herself or through his or her own I 0 Zoning Approved By
Dit,764. / /J r�7
employees, provided that such Improvements are not intended or offered for Canopy Type II 0
p
sale. If, however, the buildingor improvement is sold within oneyear of cpm- Duct-Under Ground / r
p Application Approved By Date
pletion, the owner.win 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 L/1V{Jb Date I/ '8,
o I,as owner of the property, am exclusively contracting with licensed con- ...I
tractors to construct the project (Section 7044,Business and Professions Code: 3 Duct-Ventilating 00.100,000 BTU 0100,000 BTU (0 SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who _ r I p
builds or Improves thereon,'and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ 39-b SMIP $ 4. CJ
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ 2-22;5'95- PERMIT
❑ I am exempt under Section B.& P.C.for this reason 1' Firepl/Fact.Blt. ICBG#2301 - `f nn PLUMBING $ 3o.C'c ISSUANCE $
•
Date -' Owner Heating System& Ducting PLAN CHECK $ (,•7S ENERGY P.C. $ - -
I hereby certify that I have read this application and state that the above I KO-100,000 BTU-❑100,0006 `[ 7j-I,Z0 GRADING $
information is correct. I agree to comply with all city and county ordinances - S DO ELECTRICAL - $and state laws relating to building construction,and hereby authorize repre- • $ (5.(op MICROFILM $
sentatives of t city to ter on the above-mentioned property for • PLAN CHECK
Ines. m'
Signature - • MECHANICAL i • $ IZS1/LOC) TOTAL FEE $ �77.�5
D;te - -
- _Drivers' License or SS# - ! Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK 3••so
'••..•.-.nuiding;Canary-Applicant;Pink-Accounting;Goldenrod--Assessor ' - - - - -
____________ -
U
CONSTRUCTION AND PLANNINL, 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 UFER Grnd. . 57. APPROVAL TO COVER-GUNITE ri
7. Footings 58. Electrical Conduit-Undrgrnd.
•
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test ,f
9. Water Pipe-Undrgrnd: ! 60. Backwash Lines, P-Trap, 0 Undrgrnd. .,
10. Structural Floor System f 61. APPROVAL TO DECK 2
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap ' 1 63. Heatert& Vent-Final
13. Roof Drains •
64. Plumbing System - Final ' •A'
• l
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
•
16. Rough Electric Wiring 90/ 2j 67. Fencing & Access Approval
17. Rough Wiring Sign J 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning 81J41W LFp 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 PiPerRough & Test •
72. Underground Flush
24. Roof Framing ))7 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 7fs9tee v` 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat // 75. Dry Chemical
27. Frame and Flashing ///l/y W76. Dry Standpipe
28. Lathing'& Siding , / 77. FIXED SYSTEM FINAL
29. Insulation 7 / 78. FIRE PREV. FINAL
I.
30. Drywall Nailing /OD/Kit HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION .
32. Electrical Power Meter-Final // t� 80. FOOD CERTIFICATE ISSUED s--)
33. Final•Electric - � Notes:is. Y'
A t<J ',*./`-
34. Final Heating & Air Conditioning ,s2fr/ /�92: i 4
35. Final Gas Pipe-Test 'r�fk^"D///�'QT I v
36. Hood or Canopy
37. Final Factory Fireplace 0342/
M. Final Plumbing j�
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final - ,.
42. Backflow Preventer
43. Backflow Irrigation
44. .Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations ,
47. FINAL STRUCTURE & BUILDING 2 3 g v e
48. Special Requirements Completed
49. Electric Release to Edison -
, 50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANc'Y1064,96
( . ,96 ^- / C Cl��^� vNo. Kg4 Date
'