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HomeMy WebLinkAbout2330 VANGUARD WAY - Building Permits (16) . a a CITY OF COSTA MESA Ac.�y ,ails BUILDING DIVISION F f a 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 ^O °- PERMIT NUMBER: M11-00058 PERMIT TYPE MECH STATUS: ISSUED APN: 93865202 DATE ISSUED: 04/25/2011 ISSUED BY: KJB mar JOB ADDRESS 2330M202s.VANGUARDIWN4CM.Wat' Suite/Unit:•' M202 Vicinity a ,il.,tS 4.c.tr^d.';S.•":: :...._- .",q!n"'J SQ. FT: 0 SCOPE OF WORK: CHANGE OUT FAU. 70K BTU.SAME LOCATION OWNER: HALL,MONIQUE Address: 2330 VANGUARD#M202 Unit: PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: JACOBY, ERIC Address: 10652 TRASK AV Unit: PHONE: 714-741-8384 City/State/zZip: GARDEN GROVE,CA CONTRACTOR: COLE SERVICESLicense No. 718978 Address: 10652 TRASK AVUnit: PHONE: 714.741.8384 City/State: GARDEN GROVE,CA ZipCode: 92843 CELL: 800-563-7757 • MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $38.30 PLAN CHECK FEE: $0.00 INVESTIGATION FEE: $0.00 REINSPECTION FEE: $0.00 TOTAL FEES: $38.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE O. INSPECTION TYPE DATE INTITIALS CODE i INSPECTION TYPE / DATE INTITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 7 5- _41 -1/pip t- 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv It nse., 0 Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: 0 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 rpedo nce of the work for which this permit is issued. I have and will maintain workers'compensation insurance, as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized iCe .5�� of e by this permit,and that no building structure,scaffolding,falsework,cr demolition Carries G7�— or dismantlingT� thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Gm (This sect' neeed'not be completed'/the permit is abed at one hundred dollars($100)or less.) '2 Art 2,Jec.341,Title8,Califomia Administrative Code). Policy Number: Uv C C 0 6/7 ‘z oo° 0 As owner-builder, I Will not employ anyone to do work which would El 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 the Labor Code, I shall fo hwith comply with these provisions. eA �R �L� 1/72 f/2 //7 Division of Industrial Safety Permit Number Applicant's nature 7( Date / HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE SECURE WO KERS'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 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 •• Lic.# • ♦ Class# 20 (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by „Offa• �i . I/72-57e/ each business which at any one time has on hand a quantity of acutely Contrac.r's ignarure — Dare 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 - DING 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 Dale 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 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 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 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 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 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 control officer. 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 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 2 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 q 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. nature of Legal Owner's) Date Signature Dale V...-Or �/-c/ 3057-46(3/07) rAn�r riz piicaanntt-I/(' Date / Simplified P rescriptive C of Compliance: 20(18 Recidmntial FII_ A ariune 0P'-11;-A.L7c-1:1V'AC Climate Zones 1 11110 3-i Site Arlriresee lintnrcenrenl Ageocn': I Lrr e: Permit it 12 �3o V*JUGc� g, hJ C/(144 �(SC- mit- /3ys I zs7/ ConditionedDuct msulanufc- Etiumment Tyne' I Lisa Minimum Efficiency I Flom Arca I renuiremenj [. 1 Thermostat D Pa aped Unit / / ❑ Over 40 fM1 ducts DFurnace 3UEC�0Td7COY • Setbxct:Servetby system addedo'renfaae fin Iindoor Coil ❑SUER HSPFZ(LDZpemtdinioo Lpac' / nn)nlen tppesent rnoi96e D Condensing Unit 0 EER Resistance installed) • D Ulhen },,R 6 (CZ!. r:-S) - , 1. Equipment Type: Choose the equipment being installed; if nnrt than onesyeteni, use another CF-11c-Al.'1 d-1 VAC lot each.system. • 2.Minimum Equipment Efficiencies: 13 SEER,789E W AE, 7.711SPP for typical residential systems. - - Contractor(Documentation Author's(Responsible Designerls Declaration Statement) . • I certify that this Certificate of Compliance documentation is accurate and complete. • I ant eligible under Division 3 of the California Business and I'rolessions Code to accept responsibility los the design identified on this • Cenificate of Compliance. - . • 1 candy that the energy features and performance specifications los the design identified on this Certifcale of Compliance conform to the • requirements of Title 24,Pans I and 6 of the California Code of Regulations. • The design features identified on this Certificate of Compliance arc 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.nt cation. .. .. Name: ft C . �yGO/3- I Signature: Company: - �.L /1' . . • . C.j Date: /_. . (J//I)L�7 Sg/e-1// Ib77.. 5 / . Hddr_ss:iDl9�(i' rx,f .K ��L` • I License: .r 1 P.? • ._ . . City/StatdZip: � g AQP=.0 CPf2J fC CA. .9 2—PLY-3 I Phone: - -.2./c1' i'7 L!/ -. a-'3 pO . 1 20011 lieridertlial Compliance Forms March 2010 PROJECTADDRESS: 2330 VANGUARD WY 17 f UNIT: M202 CITY OF COSTA MESA — BUILDING PERMITPEP.M NO; P 067466 OWNER'SNAME: TARTRE, LINDSAY A ADDRESS: UNIT M-202 PERMIT NO: P 067466 PLAN CHECK NO: N GOVT; N SUPP : N 2330 VANGUARD WAY COSTA MESA, CA 92626 CONSTRUCTION TYPE: PERMIT TYPE; PLU PURPOSE: OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : C/O WATER HEATER SQ FT: ' ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: A—AMES PLUMBING & HEATING (714 ) 530-2440 ADDRESS: 10422 TRASK AVENUE COMMENTS : WATER HEATER C/O GARDEN GROVE CA 92642 *****'***********-********************-*****************#*-****.N**********x*****3** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G R EQU IR EMEN TS 7000)of Division 3 of the Business and Pmtessions Code.and my erase is in tull torte and effect. SETBACK S CITY L/fC.: 00-76664 STATE LIc.: 25030 Cu 36 Date:. -Z'194 Signature:— .4 • MAIN BUILDING ACCESSORY BUILBI"NG WORKERS'COMPENSATION DECLARATION: thereby aflir hat l have a certificate of consent to self-insure or a cenificate of Workers' FRNT: FT IN REAR; FT IN FRNT ; FT IN REAR: FT IN Compensation lnfu(apce3 oC aa.cerE ified copy thereof jSectin 380,L: 3 /01 /95 MPANY: Lab.p., LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: ' FT IN POLICY REPUBLIC PARKING REQ• PROV: PARCEL : 93865202 ZNE : REF NO: " C Cenified copy is hereby furnished. 11 Certified copy is filed th the city Bu/ing Division. PLANNING NOTES> /- / > Dare: V' -2- �)-'7 # Applicant: **ia*uiF 1F*ir****ltkit****itis*****it****ie***it***aE*+F***IE if it*i4**rt*1E iF 1E**+t**iF iE+i***iE**1E****it* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (T's section need not be completed if the permit is for one hundred($100)or less). DEVELOP MENT S ER VIC E S REQUIREMEN T S 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. ZONING APPROVED BY DATE: Date: Signature' BUILDING APPROVED BY NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor c • DATE: •Code.you must forthwith comply vnth such provisions on this permit shall be deemed revoked. / %.. � /,/p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: . •• 4� which this permit is issued(Section 3097,Civ.C). *itis*******k*it%r if iE**iE if iF*-kkfF*i6*iF iF*it**,r **p.*D�E{Tt.#.jr.*.x.** .fFL.H,*. LENDER: ************ir-**it***ii**it**iE it iF*)tit*******t*********k*t*kit**************** *iF**ie ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 . 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 25% pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON—RES and Professions Code)or that he/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 9Pplicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 20 . 00 I, as owner of the Property or my employees with wages as their sole compensation, will do the work, and ine BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 7 . 00 20 , 00 0 . 00 27 , 00 27 . 00 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS——> COLLECTED: 27. 00 OVER/SHORT: . 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ' for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *************************************1t*********** ***************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL 'F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dane: Owner: PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00 I do hereby cemfy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant wiltvnll not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions, Date: Applicant: .\ I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby a Drize representatives of this city to enter upon the above-mentioned property tot inspection purposes Date: 0D— Z '9i Signature: DATE: 06/03/94 TIME: 15:13 164146 White—Building:Green—Codd Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING POO 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 COVE R-GUNITE 7. Footings 58. Electrical CondwPUndrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test i 9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, L7 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-Conduit1 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 # '+t 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 38. Final Plumbing w. , 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 • • City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 001603 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2330 Vanguard Way M-202 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-1 Occupancy. Use of Building Cnrxianinitn Legal Description 419-15106 (See reverse side for Metes and Bounds) Building Permit No G16747 Electrical Permit Nor16747 Plumbing Permit No. G16747 Mechanical Permit No. al G741 Number of apartments and/or guest rooms r ISSUED TO: Building Official . Nnwrnrt Tandina Tdmif-pd P O Bca 10843 by Beverly Hi11R. OA 90211 Date ‘.- � /'?{-S, 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 1015.46 rev. 1/83 White-Owner:Canary-Numerical File;Pink -Bldg.Permit File Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF'COSTA MESA 4865 I/03/943 £o.]p i 5. ; v CONST,R UCTION PERMIT PERMIT NO. TRACT NO. LOT NO. B G. NO. Rrolect Address .' 3• : k a h : P t i kJ : . a TYPE OF CONSTRUCTION N NEW U ADD U ALTERATION U REPAIR Applicant's Mailing Address I1 rO-r�13a( IO8Lj, .1#10274 r�� EU.HILLS 11 ❑ CONVERSION ❑ DEMOLIS�-I ❑ OTHER Ap #h9 Zone. ' Owner's Name �c.1.lJ Pl�1 Lrt�Vl,yr ! - PhOrYe /J. 0153 DESCRIPTION OF WORK GO'ADo W/ 'A2AAE �/ _ /�� - 0� I 1 _� "1- S Main Building: ILP 'd ` Z Address P O. f3(LY !0r3Y 3.1 P-1EUER1�'I N)uS, PA.9flai E q 6 Q � nnz� i ^ TV PE OF PERMIT U GRADING © FOUNDATI O��N77 ® STRUCTURAL T Front / ' /�C N Arch/Eng. CLARK- HFIIRIC'1{ License No. ` -S�� El TENANT m ELECTRICAL PLUMBING 1p MECHANICAL B 1' II • • J[ [. 1- i- •' I• Rear A • Address ❑ OTHER art/OQ Ale .0�Esce A PCT---P _ T N Contractor's Name Few L. TETR ICK Phone/ •.- 11- •I PROJECT DESCRIPTION SQ. FT. • 3 - • 1"F3CCUPANCV R-)/M-I K Right �-/7 / a /?P/4�•�,••Y 5'�/'Ve/ C-' / Left R Address(mailing) .II�SSRe�LI�o C9R/1tJGE AUEIVU6iL--/T•Q CONSTRUCTIONTVPET% -N VALUATIONS F�S)F]I}C�• $ '...t� 2pgr.�5/ TiveT E City License No. s•'s 33r%' a ZONE GRADING CU.YDS. ACRES Ping. Ref.•,M z�-5y- 68 Park.Fees $ 9- se O LICENSED CONTRACTOR DECLARATION U Remarks: � ✓<Ol •� 8/� Parking Req./Provided a- aQ I I hereby affirm that I am licensed under provisions of Charter 9 (commencing ��J / - with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: /aO C. on - •,E my license is in full force and effect. M License Class -_____8_-__L___,::::71,42,9 No 190 PLUMBING - FEES Planning Notes: _ E Date II- 14- R�' • Signature �� sI IT Can tmnrni r ....n.rq»st,Th N WORKERS'COMPENSATION DECLARATION Bar Sink Showers . lereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer - Service Sink • S f Workers' Compensation-Insurance, or a certified copy thereof (Section p., 3800, Lab. C4 STA—E-C/ Policy No. 567ion- 34 Company Slrtlt�ClNPtsI.S.FI ;I] ( Certified copy is hereby furnished. • • Automatic Washer -'.Transformer 0 15.50 KW- �J Certified o y is filetl with the city B ryys" ,sAz • 1 Date 11-f'1-et Applicant ` /.V ✓I 7 . • Construction Pole Sub. ❑ 50+KW CO MEXEMPTION FROM IvORKERS'ICOMPENSATION OECLARATIO • (This section need not be completed if the permll'is for one hundred $100)or r I a •n•• Cooking Unit.. Meter g up to 100 amps •4� less). • I certify that'in the performance of the work for which this permit is Issued, I • Drinking Fountains Solar Tankal Dishwasher 11111 Meter Dover 100 amps shall not employ any person in any manner so as to become subject to the • Workers' Compensation Laws of California. Floor • MEI •N Date Signature • • Dryers IGas ❑Electric _ NOTICE:If,after making this declaration,you should become subject to the NW Fan Motors Q'0-1 HP ❑1'h-8 Workers' Compensation provisions of the Labor Code, you must forthwith comply with such .provisions or this permit shall be deemed revoked. outlets CONSTRUCTION LENDING AGENCY ' (� F.A.U. . ■• - ■ I hereby affirm that there is a construction lending agency for the performanceer WM Fixtures S of the work for hich' ipLz @r�s+Jt i5 jstue,Q cpo 3A97 Civ. C.) 6 Lender's Name V.1 Sh )4tPO t i MC 0� 1 / Kitthen • Device Boxes Lender's Address x}719 I UJCOLN UILLAGC DR. ..ti4• SO moo. OWNER BUILDER DECLARATION SAC•• C . 9.58a�' NM Outlets - Range • Sa I hereby affirm that I am exempt from the Contractors Lice se Law for the following reason (Section 7031.5 Business and Professional Code: Any city or • Switches county which requires a permit to construct,alter,improve,demolish or repair • IIII S. any structure, prior to its Issuance, also requires the applicant for such permit Roof Drains ral Garbage Disposal - to file a signed statement that he/she Is licensed pursuant to the provisions of - he Contractor's License Law (Chapter 9(commencing with Section 7000)of ''A vision 3 of the Business and Professions Code) or that he/she is exempt Generator ❑0-5 KW ❑5-15 KW- Trash Compactor , 't%9'erefrom and the basis for the alleged exemption. Any,vlolatlon of Section 031.5 by any applicant for a permit subjects the applicant to a civil . '11 - eenalty of not more than five hundred dollars($500). Reinspection Fee $25 Issue Fee LJ $ 3 "-----len—® • �� I, as owner of the property or my employees with wages as their sole Reinspection Fee compensation, will do the work,and the structure is not intended or offered - MECHANICAL 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 1 0 thereon, and who does such work himself/herself or through his or her own ZoningApproved By �.��/� Raj employees, provided that such improvements are not intended or offered for Canopy Type II 0 PP ^"• '� Date "- sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground Application Approved By Date �Z 8 �� pletion, the owner will have the burden of proving he/she did not build or im- Bove for the purpose of sale). Duct-Structural Refrigeration System • Application Issued By 9t7 Date (.-3-Sr • LJ I, as owner of the property, am exclusively contracting with licensed con- ❑Q100,000 BTU ❑100,000 BTU ✓ tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SMMMARV OF FEES The Contractor's License Law does not apply to an owner of property who • s //'' builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ 3�. DO SMTP $ _ Tr S9 tractor(s) license pursuant to the Contractor's License Law). //,, PLAN CHECK $ '2/5. /5— PERMIT 0 I am exempt under Section B.& P.C.for this reason / Firepl/Fact.Bit. ICBG#2,;0 I T • PLUMBING $ 3O. ISSUANCE • $ • Date _ Owner , Heating System& Ducting PLAN CHECK $ •7 ENERGY P.C. $ I hereby certify that I have read this application and state that the above ®4100, 000 BTU ❑100,000 BTU GRADING $ information Is correct. I agree to comply with all city and county ordinances C.i. rr ELECTRICAL $ - LI► and state laws rel g to building construction,and hereby authorize repre- 1-.• MICROFILM $ sentatives of ity, to .ter 7s�1pon the above-mentioned property for PLAN CHECK $ r_ 'Q inspection pu s. tom ,+I '/ — MECHANICAL $ r is 63-3. 79 ✓ Signature .C/•( j Date ✓�>7-�7 TOTAL FEE $ Drivers'.License or 5S Yf - _ /_ Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ 3.n0 CMF 0865-46 rev; 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - _ - - _ r .. - CONSTRUCTION AND PLANNING POC SPA A,PPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector I. 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 - ' • 14 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water-Pipe-Undrgrnd. t! 4 60. Backwash Lines, P-Trap, 0 Undrgrnd. - 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewertine & House Connection L A /N- ��� 62. Backwash & Receptor-Final 12. Sewer Cap -• - . J tom/! 63. Heater & Vent-Final A,.14 13. Root Drains -F ,, 64. Plumbing System - Final ' 14.; Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring //4I�L,Qv 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 , • (Oftifir Vit...-- 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 057S v� 78. FIRE PREY. FINAL 30. DryQQall Nailing it CAL .VG' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final /%41°& l41/,(� 80. FOOD CERTIFICATE ISSUED • 33. Final Electric � Notes: (1/2274,-� `L f' D/� d/�ro 34. Final Heating & Air Conditioning 7;/g/gf 7-i' /„/1-„ #_ enta 1/I /$, 35. Final Gas Pipe-Test ,p4---f'Jam£ [tr�.tt.r 7 �f1� !O! 36. Hood or Canopy 37. Final Factory Fireplace 71 ,3,-yr fer 38. Final Plumbing c a-4.11-,1,� 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final • - ' 42. Backflow Preventer '`4'' ' 43. Backflow Irrigation , 1 r 44. .Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations } 47. FINAL STRUCTURE & BUILDING : II .2/ J c_ 48. Special Requirements Completed ID/ / /,u vettf 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co '.. ,r 1 • . 51. CERTIFIC9T OF OCCUpAN hfC. C/2G, . ce- , • No, Lry1 • Date {/ (lLfB11U '