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HomeMy WebLinkAbout2330 VANGUARD WAY - Building Permits (25) • CITY OF COSTA MESA `�51n 11.% BUILDING DIVISION FI lia 77 PAIR DRIVE, COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us -°� FOR INSPECTIONS CALL: (714)754-5626 .^0;ca' PERMIT NUMBER: P11-00159 PERMIT TYPE PLUM STATUS: ISSUED APN: 93865192 • DATE ISSUED: 08/17/2011 ISSUED BY: JOB ADDRESS: f30-K201-VANGUARD_WYCMMJ Suite/Unit: K201 Vicinity: SCOPE OF WORK: REPLACE 38 GALLON GAS WATER HEATER OWNER: BURCHARD DOUGLAS S Address: 2330 VANGUARD WAY UNIT K201 PHONE: 949-282-7141 City/State/Zip: COSTA MESA,CA APPLICANT: CALIFORNIA DELTA MECHANICAL INC Address: 1235 GRAND AVENUE : PHONE: 800.898-0008 City/State/zZip: SPRING VALLEY,CA CONTRACTOR: CALIFORNIA DELTA MECHANICAL INC License No. 811114 .F..i;1`l 152 Address: 1235 GRAND AVENUE PHONE: 800-898-0008 City/State: SPRING VALLEY,CA ZipCode: 91977 CELL: 866-692-5273 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 PERMIT FEE: $35.80 TOTAL FEES: $35.80 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#, INSPECTION TYPE DATF INTITIALS CODES INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing )' Ct.i 3 -1/ t" � 200 Final Re-Roof 210 Final Electrical G 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 WORKERS'COMPENSATION DECLARATIONS Owner ID verified by drive license. ❑Yes ❑ No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ 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 performance of the work for which this permit is issued. WJ 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 number are: Carrier: LI / / person is required to descend,will be made in connection with work authorized E k-e �9AY] „`.(/ by this permit,and that no building structure,scaffolding,falsework,or demolition YELJf I or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Gry (This sect n ed not be completed if the permit is valued of one hundred dollars($100)or less.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: n .21 ❑ As owner-builder, I will not employ anyone to do work which would ❑ 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 Dale the Labor Cod shall forthwith comply with these provisions. R• �I / ,1/ Division of Industrial Safety Permit Number: Applicant's Signature dld1e HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO 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 ❑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 Code, and 2 Does or will the applicant or present or future building occupant need to file my license is in full1force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No Lic.# p I I I 'f Class# C — (Section 25533 of the California Health and Safety Code, with some •�/I�N'yV-YR— exceptions, requires registration with the Costa Mesa Fire Department by i Di / each business which at any one time has on hand a quantity of acutely Contractor's Signature Dar 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 CONSTRUCTION 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)? 0 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 Safety Code been fully complied with? ❑Yes ❑ 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? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished 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 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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 ❑ 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. ure o Le al wnehs) Dais!// Signature nate 305]-46(31071 7 And/or Authonzed App., O to CITY OF COSTA MESA o5� f, BUILDING DIVISION A a lI t" 77 FAIR DRIVE.COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: E10-00298 PERMIT TYPE ELEC STATUS: ISSUED APN: 93865192 DATE ISSUED: 12/17/2010 ISSUED BY: RMD JOB ADDRESS: 2330 K201 VANGUARD WY CM Suite/Unit: K201 Vicinity: EXTERIOR STAIRS SCOPE OF WORK: ELECTRICAL PERMIT TO REPLACE A/C UNIT WITH 1 DISCONNECT. REF#:M10-00162. OWNER: BURCHARD DOUGLAS S Address: 2330 VANGUARD WAY Unit:UNIT K201 PHONE: 949-282-7141 City/State/Zip: COSTA MESA,CA APPLICANT: ZAMORA,CARLOS Address: Unit: PHONE: 818-735-7871 City/State/zZip: CONTRACTOR: AVIS PLUMBING HEATING AND AIR CONDITIONING INC License No. 555289 Address: 1240 N JEFFERSON STUnit: UNIT Q PHONE: 714-632-1317 City/State: ANAHEIM,CA ZipCode: 92807 CELL: ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $24.60 Reinspection Fee $0.00 TOTAL FEES $24.60 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. coot s INSPECIION TYPE DATE INPIIALS CODES INSPECTION TYPE DATE IN717IALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �q/ 200 Final Re-Roof 210 Final Electrical c LI ( 2 -24 I Y�'ln- 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivvSe. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations:' -Driver's License No. Expires: ❑ 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 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 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 vAiich a number are: person is required to descend,will be made in connection with work authorized Carr— ie' `, by this permit,and that no building structure.scaffolding,falsework,or demolition Ctis�1 C✓"v or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sedion'need not be competed the perms is valued al one hundred dWars(5100)or leu) 2,Arta Sec.341,Title 8,California Administrative Code). Policy Number: (,)S'S. °CQ¢ o 0 As owner-builder, I will not employ anyone to do work which would Li 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' co ••e -ation laws of Califomia. and agree that if I should become subject t• the •rkers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code.I hall f•-' 'th comply with these provisions. t.31. �/ Division of Industrial Safety Permit Number: App .nf• .core �vJ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE I. 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 Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lio #'_s Q ,Class St -Cw (Section 25533 of the California Health and Safety Code. with some exceptions, requires registration with the Costa Mesa Fire Department by Ili 17' ( It each business which at any one time has on hand a quantity of acutely co pe. cos s re Dace, 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). a 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 Safety Code been fully complied with? 0 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? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished 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 0 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 properly, 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 0 No thereon,and who does such work himself or herself or through his or her Own 8 (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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: I a contractor(s)license pursuant to the Contractors license Laws.), certify under penalty of perjury that I have read this application and state that ❑ 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 • to Mesa to enter upon the above-described property for inspecti•• purpos-s. I agree not to occupy or allow occupancy of any building author' ed by this p•-,rug.until final inspection. Ownerts) Date Signature Date -1 305746p/07) 114 /-y n r thorize4 Applicant para Mft a. CITY OF COSTA MESA ,tqt. BUILDING DIVISION PERMIT NUMBER 1-' '•.'4 ' DEVELOPMENT SERVICES DEPARTMENT. k .04 PERMIT o� P00-00236 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2330 VANGUARD WY Status: ISSUED Suite No K201 Applied: 05/08/2000 Issued: 05/08/2000 Vicinity: ISSUED BY: Parcel Nunmber: 93865192 Applicant: LORIE GLOVER Address: Phone: 714-432-8332 Zip: Owner: EICHELBERG, PETER 4.40 lb Address NICHOLAS 6 4kb1 COSTA MESA,CA Phone: 714-432-8332 ' 2330 VANGUARD WAY#K-201 Zip: 92626 01. ' r/ Contractor: COAST ROOTER PLUMING HEATING &AIR CONDITIONING Address: 2737 S CRODDY Phone: (714)241-1414 SANTA ANA,CA Zip: 92704 License: 529127 Arch/Eng: Address: Phone: Zip: ' License: SCOPE OF PERMIT WATER HEATER CHANGE-OUT. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) 50.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) • $0.00 0 Sink,kitchen 50.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS/SPECIAL CONDITIONS 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 DECLARATIONS j 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. Ep I have and will maintain workers'compensation insurance,as required by section 3700 of t e Labor Code,for the performance of the work for which this permit is issued. My work '/'cpm nsa/t�ion Insu ance carrier and policy number are: Carrier: 1 I.1 ` (. Q,YI /� Policy Number: NDIOA A �' 7 vr (This section heed not bbba completed it the pe tt is valued at one hundred dollars(St 00)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 I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. '-'-.1 Applicant Signature: _..,...---e— Date: 51—O D // WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOI I ARE($100,000).IN ADDITION 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(commenting with S Ion 7000)of Division 3 of the Business god✓Professions Code,and my license is In full It force and effect.Lic. S I /s'7 Class s ✓ `y Contractors Signature: Date: C-8-nnL 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). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I em 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 civ i penalty of not more than five hundred dollars(5500).): ❑ 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 ProfessionsCode: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 property 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 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-properly 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 AdmInistrat ve 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: I Will the applicant or present or future building occupant need to fife and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 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 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 wit 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 tho 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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ 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? 0 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? 0 Yes 0 No B (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. i,,'lure0 ,-gel Owners) G/ Date `) _� S-P-ba , • •uthorized Applicant Date • son i INSPECTIONTYPE MI I[allALS CODE( INSPECTION TYPE p ff !METALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing o l-25-09 !0 i N 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 2446-46 _ 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 Q 11481 a / 337 •I 1` p,01 711/_:1 P:U. Box 1Uki4.3, BeV.li11ls9U21_� ��J - • , Applicant's Mailing Address TYPE OF CONSTRUCTION 4 NEW LJ ADD U ALTERATION REPAIR ' Project Address' 2330 Vanguard Way • Pj'201 I0 CONVERSION ❑ DEMOLISH ❑ OTHER - Owner's Name Newport Landing, Ltd. Phone 274-0953 . DESCRIPTION OF WORK - ZONING REGULATIONS Address P.O.Box 10843, Beverly Hi11s,CA90213 Condominium / B 1 ' (j L_ C-2578 TYPE OF PERMIT ® GRADING Q FOUNDATION 6.J STRUCTURAL A.P.# "TI-i' ) VI-N ZONE )2� Arch/Eng-Clark & Hedrick, Inc. License No. - • PLNG. REF.# e ) --r-1 , I��yIILDING . ❑ TENANT ❑ ELECTRICAL 10 PLUMBING ❑ MECHANICAL 7A I-R'� I/ ILI aW I D v rn cT Address 11969 San Vicente B1.#205 L.A. 90049 - El OTHER TO BUILDING (A L B C /'1 yy • Contractor's Name' Phone •.PROJECT DESCRIPTION SQ. FT, 1170 OCCUPANCY • R-1 PROPERTY LINE ft kA G REAR YARD (TO P/L) LACI 1 CONSTRUCTION TVPF V - 1 hr. VALUATION$61.500 • LEFT SIDE YARDSLI I C,I b �IIGHTSIDE YARD Ll ) I•' h fried Address(mailing) L/ft CT` _a . - ZONE R-4 GRADING CU.YDS. Site ACRES PKG.SPACE REQ. n 5 PROVIDED �'1 5 License No. ___ Os �Jf LICENSED CONTRACTOR DECLARATION - Remarks: Building (IN- Unit 201/Type BSTREET WIDTH 56I PARK FEE$ • I ,t ) � I hereby affirm that I am licensed under provisions of Charter 9(commencing , I 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 - .HOLO;1'UK JYI:LIA4 tC1:ltU11C1:tYlCn ti Date Signature • Bar SinkSewer Cap ELECTRICAL • ' 'KERS'COMPENSATION DECLARATION •aby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer -- Sewer Connection Automatic Washer _ Meter Dover 100 amps , of Workers' Compensation Insurance, or a certified copy thereof (Section - 3800, Lab. C.) Backf low IrrigationSolarCollectors • - Construction Pole Sub Panel _ Policy No. Company - Cooking Unit Sub Pole 8 Certified copy is hereby furnished. Bathtubs . Solar Piping Certified copy Is filed with the city Building Division. • Dishwasher Motors D0-1 HP 011/5-8 Date • Applicant • Clarifiers Solar Tank . EXEMPTION.FROM WORKERS'COMPENSATION DECLARATION Dishwasher Swimming Pool w/Spa Dryers ❑Gas ❑Electric Inc.Solar Os-15 HP D16-15+ . (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 - 1: F.A.U. Pole Light Workers'.Compensation Laws of California. . Floor Drains i Water ' Date Signature ! Fixtures Range_ ' • ' NOTICE:If,after making this declaration,you should become subject to the - Floor Sinks -. - erF(jato - .. _ . Workers' Compensation provisions of the Labor Code, you must forthwith, {� y' Device Boxes Sign:comply 'with? such provisions .or this permit .shall be deemed revoked:, Gas Service 'Outlets ' Wa 16ice i 9 . CONSTRUCTION LENDING AGENCY A I I hereby affirm that there Is a.construction lending agency for the.performance Interceptors . . n Outlets • !Standing Sections of the work for, which- this permit Is issued (Section 3097 Civ. C.) ( -, ' j+ . I( `� Switches • Trash Compactor Lender's, Name- _ - Kitchen Sink pV(.�df'7 ( Vvs Lender's Atltlress• _ •Lavatories '� • Garbage Disposal • OWNER,BUILOER DECLARATION - C I hereby:affirm that I am exempt from the Contractor's License Law for the .Jl • Generator D0-5 KW D5-15 KW following reason (Section 7031'.5 Business and Professional'Code: Any city or P-Trap ' . .1)\ 8� county which requires a permit to construct,alter improve,demolish or repair ` Transformer D15-50 KW any structure, prior to Its Issuance,•also requires the applicant for such permit ' • Roof Drains t fide a signed statement that he/she is licensed pursuant to the'provisions of - �� . 1 050+KW'' iReinspection Fee ' $15 ,. ontractor's License Law(Chapter 9(commencing•with'Section 7000)of . ` — 1 _, ; _ V Rein ectidn Fee ;;ion.3 of the Business and Professions Code) or that he/she is exempt Showers , - W $15 - , efrom-and the,basis for the alleged exemption. Any violation of Section . - . - Meter Dup to 100 amps 1 ,Issue Fee '$ 3 •7031.5 by any applicant for'a,permit subjects the'applicant to a-civil Service Sink Issue Fee , • enalty of not more than five hundred dollars($500): ; $ 3 Zoning Approved By f •• r 1 US"1 ' e Data 17 I 79 I M I, as'owner of the property or"my employees with wages as their sole MECHANICAL / g compensation will70 the work,and the structure is not : Theetl orofferedApplicatjon Approved By GUO L nate 14-30-7 for sale (Section 7044, Business and Professional Code: Contractor's License Law does not apply to an owner of a propertywho builds or improves • Boiler - i Refrigeration System gpplication Issued By - 'Date thereon,eand'.who;does such work,himself/herself or through his or her own -' employees, provided that such improvements are,not intended or offered for I D0.100,000 BTU D100,000BTU Duct-Under Ground sale. I , the own the building e the u den of pro i sold within one your of com- SUMMARY OF FEES i I Diction, the owners will have burden of proving he/she did not build or im- - 4 ,� / r ve for the purpose of sale). Duct-Structural System Repair/Alteration BUILDING PERMIT $. Si? 9'�O SMIP $ 1 I as 'owner of the property, am exclusively contracting with licensed con- roc ars to.construct the project.(Sectlon.7044,Business and Professions Code: Duct-Ventilating,_-_ .- • - I iM- 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 ❑ Multiple D, PLUMBING $ I , tractor(s) license pursuant to the Contractor's License Law). , GRADING - $ D l am exempt under Section B.&P.C.for this reason • Fire I/Fact.Blt. ICBG# i - PLAN CHECK $ i I • P ELECTRICAL ( $ - I $ , . Date •� F�tZecaner' s -.a -- ( i Heating System& Ducting ' t •• MICROFILM • I hereby'certify that I'have read th 5 application-and state than the above • . ❑0.100,000 BTU D100,000BTL- - , • •PLAN CHECK $ ! $ i information is correct. I agree to comply with all city and county ordinances ' I l I i TOTA L'FEE 1 $ . and state laws relating to building construction,-and hereby authorize repro- Hood or TypeMECHANICAL $ .• sentatives of thi city. to enter upon the above-mentioned prpperty for I ❑ Reinspection Feet $15 ,PLAN CHECK $ ' LESS S gnatt r p-fp&'-s. Z�S Canopy Type. II D. Signature _�/_i_. :/ Jr' �:./ Da �✓�J ; ADVANCED PC $ q 3J Drivers' License or'SS# • , . • Registers , Issue Fee $ 3 • • FINAL FEE $ Se'`�3- CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - . Q CC,ONSTRUCTION ANDfPLANNING ' 1 -`-,'• i,;��*- ;!-.-;?!Pc SPA , ,, -. 0, 1 V S c - -- . s,Date ' Inspector .A - ` - - Date Inspector �APP�ROVALS �, earmlt:: N _ c •, , ,:-APPROVALS, Permit, - r, ial ,. _ "7--4.- _ - m .` Te'mpprary Electrical Service or'Pole • ' _tb _ fir :52 'Pool &E quipment Location a, I '- - i ': D Soil Pipe Uhdrgrnd.y m ' S .c 3 .ti 537'Steel Reinforcement "• ,- . ' " '' - 3 Electrical Conduit Utility-Uhdrgrnd.I - • ,_ ti ,g, - 1 ..54'Forms' r . .„---,7 ,%_ _ t II , 4r.; El Conduit-Undrgrnd y i , -• 55.;Electrical Bonding _ - -,• . S Steel Reinforcement; i , - , 7 ; I - - - c ''56_ Rough'Plumbing; l&Pressure:Test _ 6: 'Electrical LIFER Grnd.i Ito ; 1.• ' 1• ''•' ` o ' - 57. APP�ROVAL'TO;COVER GUNITE • '- I i 7. Footings I ' 4 `- . _ -58: Electrical -Conduit Undrornd'�. - - V 8. Fountlation; '1 I I I ' t _ ; y _ 59. Gas,Pipe,'D.Undrgr`nd.-,Test - - - 9. Water Pipe-Undrgrnd. I ' `� :'60. Backwash-.Lines1P Trap '0 Und?grnd.-I c I ` , , 10. Structural Floor System 1 . , . 61, APPROVAL TO:DECK • - • - • _ 11. Property'Sewer Line'& House Connection n -62. iia -Final- - ,, • 12. Sewer Cap 1 cr .''' 1'63. Heater &Vent-Final . ,it t 13. Roof,Drains 1 , :'64. Plumbing?System':Final '.; ' -r > . 1 c. < 14. Rough Plumbing I i - - F' r ! i•-65. Electrical-Final - ` • - ' g, 1 T. n - h 15RougElectrical:CAlldult , -",' - " ` 0.16, "Rough:Eleciric,Wiring I F 1 ;17: :to % hTh-PrIT I"''67:-Fencing 81"-Access APProval c. i , • = . 17:IRough Wiring`Sign2 c :• I • 1. , " l 1 I= I •` 12 i ' '68.1 APPROVED FOR.PLASTERING ' - !I 18?IRto"ugh Electrical=T'Bar Ceiling' 'I I ; i I I I = I'1 1 . r69.' POOL/SPA SYSTEMS.F!NAL I •^. ' 19. Rough Heating& Air Conditioning 1 - 1.1 1 ! _ ; 1 I FIRE DEPT.,REQUIREMENT ' , ;; 20, Roughfactory Fireplace. I I I APPROVALS ' • Permit# ' ` I 1 • I'- . k I.• 21. Duct's,"in Structure!'t ' 1 .1 '{ ' 70., Undergrnun[LHydro 1 I . , ' , - 22. Ducts Ventilating '_ � ; ':-I I ' ' I I 17A 'ProduJPiping O,Gas ❑Oil •' I ;• . '423. 'Gas'Pipe-Rough &Test ;; 1 ilk, �� I I 'r12n Underground flush 24. (Roof Framing) ' ; i (11 11 I . • I•. 'r : I: : :Pi t•731 Undergrnd.Storage Tank O Gas 0 Oil , • ' :I 25. Roof Sheathing ii . _ 1: , ! -,/ 'Ici '.:'Overhead Hydro ,r---- - r ,1 26. iT-Bat Ceilirig (Structural) & Monocoat' 111 ' _, � a I' I -i 75iDry CherniFal . ' ' ' .I ,. a 2 }L27. Frame and Flashing, 2 I I Ii . 1 ; I r• f �n 5�! Dry Sta pipe ; '• _ . I ` ` t 28 I1L:athing &`Siding- " - i ' 11 • I 1 1 !.`1 AI I 177: FIXED,'SYSTEM•FINAL IIw , t d If .tD1.1 I ' ? •_291.,Insulation ' - :1.•. I 11 - I I ' 1 1 =! 41 ;78! FIREA;REV. FINAL a 'I-30.,Dryovall Nailing I - ' ° I 11 II 1 I : I ,/res„. • 1_ 4'Notes: // v l Ft .0 _ , a 1, ) I -rel- I^ r-17-r,,-- -I - - -r- , r31:'Plaster Brown Coat I I I , , I I -,..t.,.., j" /A' I _ • . . 7 1'J ,- r 11 1 - I I I 1 I , I 1 ref I I � I f.,' 32- Electrics LPower Meter-Final 11 1133./Final Electric I•--.. I r 5 1. ..,. ' 1 1 1 .. ._ ' .. .. S 34. Final Heating&Air Conditioning d 1 i 11 , , I ' 1' r I I 35. Final . ii .“teI-, I . I '1 '-'I t j .. I :. i .' I I, 1' _ : I - I .• ,; - 36. Hood brrcanopy I c-1= ,;I ; I : ` ! '' I 1 ' ' r _ - 1� • :I u II I • ':, I- I .. 37. Final Factory Fireplaces`. I -- i 1 ; I i - I a i I I .' I I 'I c.• ' . , , 38. Final Plumbing, I I 1 t •l •ii ! _ ' ; ' i I ' ' ; ' : : SI t 1 , _. 1 39. Water FSe1 vice-Final I 1 I:_ i - I - I , I I ; , - ; 40. Gas Service-Final 1 i ' t p 1 I - • ' .1 , 1 1 I ,-. I I I I ... ' 41. Solar Domestic-Final I I , 1 I t ;J. _.! - . . 42. Backflow Preventer ; I I 'r .1_1 1 _ , .- ' 1 _1 I-_ _ • • 4. 43. Backflow Irrigation .' I ; , •r• _ ' ; , . c ' ' • , ? I I I . 1' - I .tc I - • "' ' ' 1 ,1 I - 44. Landscape.Irrigation_SystemI . 112 _, I _ . �I e 1 , 1 :..; . ' 45. Sound`Attenuation' I ' 'c� I -+ - , c, I il :I I ' - •I . • 46. Handicap Regulation's 1 . ; Ir. !! i 11 , 1 I ' I ' , '- - (' 47. FINAL STRUCTURE& BOLDING : I f I �:. ! I I 1 I • I i i • . 1 • • I �, , : , 48. Special Requirements Completed . I _ I 49. Electric Release tojEdisod 1 ( ;' .I__)_�� I I ' - I__ I 4_ : __I - 50. Gas Release too Southern Califorriia Gas Co i• 1 I I , 1 I I ' I , 51. CER T!IFICATE;OF. OCCUPANCY F. i___!__.! . _ 1 , -.j. . _. ; { . _L_ • No 1 1 I Date ' I • 1 ' 1 I I , City of Costa Mesa (1 Development Services Department CERTIFICATE OF OCCUPANCY No. 001592 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 7.110 Aram-nun-el tdav K-201 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group P-1 Occupancy. Use of Building ('rmrlrynininrn Legal Description 419-1 ci-r1F • (See reverse side for Metes and Bounds) Building Permit No fiCQQ) Electrical Permit No. r_1 AS1R9 Plumbing Permit No. r1FPP0 Mechanical Permit No. A16882 Number of apartments and/or guest rooms ISSUED TO: Building Official i • •- c t^- Newport Landing Limited P O Box 10843 by Beverly Hills, CA 90213 ; Date - J�'- - IJ / .\ 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 lel U.B.C. CMF 101546 rev.1/83 White-Owner;Canary-Numerical File;Pink -Bldg.Permit File 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • .CITY OF COSTA MESA • PERMIT NO. TRACT N LOT NO. BLDG.NO. 5724- 1 / I5/85 'a 3:.3.7' 7' ••CONSTRUCTION PERMIT ( 1 LeeZ jZ i/71/�j/6/ f K p J Project Address a • A an; e 1 p' -. • G TYPE OF CONSTRUCTION vV NEW ❑ ADD Li ALTERATION K. REPAIR - ' Applicant's Mailin Address 90 1;').X I1Oy f�l4.�• EU.- HLLI-1 ❑ CONVERSION ❑ DEM/pc�1t�J,SsH ❑�jO/T�HER��9s&.36 ye,,r �/+ q,p-5(6 y/9� /5J C I2one ,Q , •1 Owner's Name kJGWFORT LAK)DI S LIG Phone • - • DESCRIPTION OF WORK �ONpO 6x7246.6_ IS ILS l�.M u•-•• p� I !+ a0; 1 f 3 �I S Main Building: ing. 2 Address PCO. 1.30X 10R43; IDL VERI-y HIUSr LR. �O.pTYPE OF PERMIT LI GRADING FOUNDATION y� STRUCTURAL ` - E Front ,p esti N Arch/Eng. Y LAR Ie —HEDR\ek License No. e-58 NI CpI IN T ,r)��t� RL �s 44 ❑ TENANT rP ELECTRICAL WI PLUMBING w MECHANICAL B Rear I 7 1 (�� Address 11969 • SAN 'UKant 191. L.Pt• 0049 El OTHER A l/ T n.�gre<-sT / N v' Contractor's Name 1OI1L q Rri< (1/ PhIn I PROJECT DESCRIPTION SQ. FT. I ;.RR OCCUPANCY-R-I/M-I C Right 3G 19��r,F� f�,,y'• ' R ••� Address(mailing) I I?�S O LA GRANGE QIIE., LA.g0or1.5 CONST RUCTION TYPE IVI VALUATION$ 73,79 g Left 6' 7 r/Ptai^„S� -5 Dry• • ' E 33121a ZONE GRADING CU.YDS. ACRES - Ping. Ref.# •- 9e/ 8 Park.Fees $ 2 ey O City License No. �-C - / 3 U LICENSED CONTRACTOR DECLARATION Remarks: �C- 59/ •^ 594 Parking Req./Provided '�- Ihereby affirm that I am licensed under provisions of Charter 9 ns Code, nI R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: Ray � E my license is in full force and effect. /J • License Class l7-I (�{ �ylc . C'R�� • PLUMBING FEES Planning Notes: • 'M Date_ i- :19-P14 Signature /� -- •E WORKERS'COMPENSATION DECLARATION Bar Sink Showers NAT TN 'Ern C^Fri AT prnrimSP PITS N I hereby affirm that I have a certificate of consent to self-insure or a certificate ) 'S of Workers' Compensation Insurance, or a-certified copy thereof (Section Backflow Preventer Service Sink S 3800, Lab. C.) s1 i Backflow Irrigatioh Sewer Cap • - - r r - ELECTRICAL FEES-' Policy No. 567)3&-AI Company StI* Cor�P. SIMS. FIMI - D. - . ��yI Certified copy is hereby furntshed. Bathtubs Sewer Connection- I I co W Certif ietl opy is filed with the city B,QCdfng pill . _ - ' "1 1 Automatic Washer Transformer 0 15-50.KW. / oo Date II- Ii- SL� . Applicant Llf� - Clarifiers Solar Collectors,; - . . • - Construction:Pole Sub. rq�L' ❑ 50+KW EXEMPTION FROM WORKERS'COMPENSATION DECLARAT ^/ Dishwasher - / �oU6�O4/[y 7 g I \p • S,CO(This section need not be completed if the permit Is for one hundr ($100)or Solar Piping .Cooking Unit Meter \ to 100 amps v less). - - • I certify that in the performance of the work for which tnis•per u is Issued I Drinking Fountains Solar'Tznk - e - t Dishwasher •r Meter ❑over 100 amps- - 1. qj 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 .. Dryers Gas DElectric Sub Panel .eis CO Date Signature s - - NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal • ` 2 Fan M 00'110.1 HP ❑1X-8 Workers' Compensation provisions of the Labor Code,'you must forthwith - - - - - ( otors Y-' CO comply with such provisions or this permit shall be deemed revoked. [Gas Service . ..5-"Outlets Water Closet CONSTRUCTION LENDING AGENCY ` ,LD 7 F.A.U. Inc.Solar 09-15 HP 016-15+ I CO I hereby affirm that there is a construction lending agency for the performance Interceptor's / Water Heater - ' a CO /3 Fixtures :Microwave r0 Of the work for p7ch t i e it 1s Issuep Sec pn 3.097 Civ. C.) ZT� Lender's Name YUt--19 _K h•1FRIUI ISFR M0K CrF1Gr Cq / Kitchen Sink Water Service Device Boxes Pole Light Lender's Address 9liI IA1CfsiAi UILIAGE .DR.j r�lSipar.�col - • OWNER BUILDER DECLARATION �S/- CJ RN .ST13 [�/F,95T&a7 �I-evatories - / 41/Js' it - , �0 'I,"Outlets ' - Range S00 I hereby affirm that I am exempt from the Contractor's-License Law f r the p_Tra !r iY /- following reason (Section 7031.5 Business and Professional Code: Any city or p, -• 19 Switches. Sign I 5 QQ county which requires a permit to construct,alter,Improve,demolish or repair — - — r -any structure, prior to its issuance, also requires the applicant for such permit Roof Drains • ( Garbage Disposal - Standing Sections DD 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 License ' cense 3 of the Business and Professions Code) or that he/she is exempt • . . - _ Generator 00-5 KW 05-15 KW Trash Compactor ' therefrom and the basis for the alleged exemption. Any violation'of Section - ' .,,t-rt-i- A 7031.5 by any applicant for a permit subjects the applicant to a civil - 44 Z enalty of not more than five hundred dollars($500). Reinspection Fee $25 Issue Fee- $ 3 Zr 1-1 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 MECHANICAL FEES for sale (Sec/Ion 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 I 0 a thereon, and who does such work himself/herself or through his or her own - - r employees, provided that such Improvements are not Intended or offered for Canopy Type II 0 Zoning Approved By ��- 7 Date sale. I1, however, the building'or improvement is sold within one year of com- Duct- Under Ground , Application Approved By • 'I0' - Date /©t pletion, the owner will have the burden of proving he/she did not build or'im- - 1�f/ prove for the purpose of sale). Duct-Structural i Refrigeration System Application Issued By 4144 • Dat: 11 :1 LJ I, as owner of the property,am exclusively contracting with licensed con- ❑0100,000 BTU 0100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Z Duct-Ventilating , 4 yL r 'SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ ' 355.00 SMIP ' $ S-17 , tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK $ 29)0• 73 PERMIT • ❑-1 am exempt under Section B.& P.C.for this reason ' I Firepl/Fact.Bit. ICBG#25D/ 14- PLUMBING $ .cr, 'ISSUANCE $ • Date Owner Heating System& Ducting - I PLAN CHECK $ ENERGY P.C. ' $ I hereby certify that I have read this application and state that the above / 00100,000 BTU 0100,000 BTU information is correct. I agree to comply with all city and county ordinances - - - y' 00 ELECTRICAL $ . 3 .1..(0 GRADING $ and state laws rela . to building construction,and hereby authorize repro- O MICROFILM $ • sentatives of h' ty. to ter u n the above-mentioned property for PLAN CHECK $ I S' Inspection pu .. Signature Date / I ' MECHANICAL $ I C-00 TOTAL FEE . $ h45.7-7 / Drivers' License or SS% Reinspection Fee $25 _ Issue Fee $ 3 PLAN CHECK $ S•e0 an CMF 0865-46 rev. 7/83 white-Building;Canary - - ' / g; y-Applicant;Pink-Accounting;Goldenrod-Assessor .. .. - - 4:ONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector '..!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 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. Foundation 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 7/2Yr :� 62. Backwash & Receptor-Final 12. Sewer Cap - /�7 ' ' ' 63. Heater & Vent-Final • 13. Roof Drains • 64. Plumbing System - Final , 14.-Rough Plumbing 7/Y ill 65. Electrical-Final 15. Rough Electrical-Conduit • - • 66. Solar System-Final 16. Rough Electric Wiring 741CO ift-J 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-P 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 7Zy �1�� 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 1• 27. Frame-and Flashing �/` /br �L 76. Dry Standpipe 28. Lath.ng'& Siding ` r 77. FIXED SYSTEM FINAL 29. Insulation %(13'1( VL 78. FIRE PREV. FINAL 30. Drywall Nailing gitOrc- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat N 79. FINAL INSPECTION 32. Electrical Power Meter-Final L 80. FOOD CERTIFICATE ISSUED 33. Find Electric -(41- Notes: 34. Final Heating & Air Conditioning /J/Y�i/ B r Ill 31-. /�i} nig 35. Final Gas Pipe-Test /MAYA( J 0t/ nig 36. Hood or Canopy 37. Final Factory Fireplace 4,/// �]j. 38. Final Plumbing - "' { 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer �r 43. Backflow Irrigation 44. ,Landscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING 2..‘5,)56., . 176, 48. Special Requirements Completed er yG , 49. Electric-Release to Edison 50. Gas Release to Southern California Gas Co o • ' 51. CERTIFICAIEE OF.O00UPANCY /1 No. [S/�/ Date2y�..t �49G