HomeMy WebLinkAbout254 MAGNOLIA ST - Building Permits 4PP 4 ' . - \
--c--- _.__,, eorae]lines and sign all appropriate declarations. - /�
OF'CnsTA ME,§ STR UCTION PE' ( • PE MIT NO. TRACT NO. •LOT NO. UNIT NO.
:.c >, a L I / '�GA(�/ 3 -.. .P Z g�l S 9�/ �' — ,439; .e/2E/ .7 = .
Rt Address l' y U REPAIR. I 1
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��� TYPE OF CONSTRUCTION U NEW L�ADD U ALTERATION I f
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4ppicanL's Mailing Address CAM , l
1a9S.T ¢.GH 1 W HiQ S/ •-. ?❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p,# `( p Zone p
Ov ner's Name r Phone "��'-� �L - V-,�ti/�.'Li fit)D �'� ._O Z - . I. R I - 1
-( t.. •DESCRIPTION OF WORK/USE OF BLDG.
•t. Address _re �A\9 • .'r r ( S Main Buildin• g: ,Accessory Building: n
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' Arch/E-gr ' License No.,.: ' •y'' •- '9 ' - TYPEOFIPERMITr� ❑ GRADINGI�LI FOUNDATION .STRUCTURAL T .Front; 271' -it Q./t, Mie o
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'^❑ TENANT Or ELECTRICAL aPLUMBING ❑ MECHANICAL B Rear • a, Q,�y� ' N
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/Contractor's• Name Q . -Phone y❑ OTHER - C Right' / , N
yB .•PROJECT DESCRIPTION' SQ. FT. OCCUPANCY
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/ Address(mailing) J �••�� ll''==...I: K .f G
- • -:CONSTRUCTIONTYPE - VALUATION $ .l +7OV $ Left . " f.9/ ,
• ./City License No. • - /,ZONE -• GRADING CU.YDS. ACRES I , I R
LICENSED CONTRACTOR DECLARATION % ` , . v Ping. Ref.# I ,Parking Req./Provided E
I hereby affirm that 1 am licensed under provisions of Charter 9 (commencih9 Remarksi r - Planning Notes:' /.� - .� ' Q/N/ _Lie �.}.�(,y4.M
. with section 7000) of Division 3 of the Business and Professions Code, arid = T
I • my license is in full force and effect. 4 •, - • /�;�W,�vu�s�.�(,[.�, /j Q,C�!
License Class License No. •
�' Al 1 ' 0 m- 4n�Qf Q' '
V n� elil S
Date Signature - '` Gam) PLUMBING - c,{�IQ.�� ,
'ttORKERS'COMPENSATION DECLARATION .. ', .
rr Bar. Sink Showers - ELECTRICA LI FEES
I1 hereby affirm that I have a certificate of consent to self-insure or a'certificate Jr
of Workers'-Compensation Insurance, or a certified copy'thereof (Section • -
• Backflow Preventer - Service Sink •
3800; Lab. C.) '!F L Automatic Washer Transformer ❑ 15-50 KW -
,t policy No. - Company - Backflow Irrigation Sewer Cap - _ ❑ 50+IKW
jI L� Certified copy is hereby furnished. Construction Pole Sub.
❑ Certified copy is filed with the city Building Division. Bathtubs • Sewer Connection C• ooking Unit, Meter ❑up to 100 amps , •
Date Applicant - - . '
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ` 7' Clarifiers Solar Collectors- _ • Dishwasher Meter Dover 100 amps - -,
(This section need not be completed if the permit is for one hundred J.$100) orY,` . '
less). Dishwasher Solar Piping • . Dryers ❑Gas ❑Electric Sub Panel
I certify that in the'performance of the work for which this perm itis issued, I ' - -
•
shall not employ any person in any mann so as to becomes lett to the ' Drinking Fountains Solar Tank •
Fan Motors❑0-1 HP ❑1'h-8
•
• Work S' Com eo�a an Laws of CaliforniLe • r
kr Date�.Ly/-t' phi 0 Signature ' ' floor Drains Swimming Pool w/Spa F..A.U. • - Inc Solar D9-15 HP ❑16-15+
11 NOTICE: /f,after making this declaration, you should become subject to the — - -
Workers' Compensation provisions of the Labor Code, you must forthwith FioorSinks Urinal Fixtures ! • - a°' %n
comply with such•provisions or this permit shall be deemed revoked. �. 3 Microwave , eti U
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet •
Device Boxesv' •" POI¢ Li ht '.•r
I hereby affirm that there is a construction lending agency for the performance _ t ,.! g
of the work for which this permit is issued (Section 3097-„Civ. C.) - WaterHeater '''.° i, f
Interce• ptors /4 ^n ” 1' • I C'
Lender's Name - L Outlets -� ter' Range 7l• (�
Lender's Address t� - - Kitchen Sink - - Water Service - - - - Switches ' ' - - - - ^ r
OWNER BUILDER DECLARATION • -. -'! r Sign. 4r
I hereby affirm that Iam exempt from the Contractor's License Law for the Lavatories ` ' Auto-Wash •
Q Garbage Disposal �:>'- -� St-eliding ing Sections
following reason (Section 7031.5 Business and Professional Code:Any city or - -ib
county which requires.a permit to construct,alter,improve,demolish or repair P—Trep Laundfy Trays Generator ❑0-5 KW❑5-15 KW > Trash-Com actor .+r�"
any structure, prior to>its issuance, also requires the applicant for such permit -- a, P _
• to file a signed statement that he/she is licensed pursuant to the provisions of - - l -
the Contractor's License Law(Chapter 9 (commencing with SectiomJ000) of ROOF Drains 1 + ,,.n i?, _
Division 3 of the-Business 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 applicant to .a civil -
enalty of not more than five hundred dollars,($500).
I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee' $ 3 - - ' .
compensation, will do the work, and the structure is not intended or offered" • • Reinspection Fee I•$15 • Issue Fee • .$ 3 _
for sale, (Section 7044, Business and Professional Code; The Contractor's - - MECHANICAL FEES - ./
License Law does not apply to an owner of a property who builds or improves _ _ _ ,
• thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REOId RE,OIIENTS: ' �j 2�-
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ /'V��'( 1----: d8
sale. If, however, the building or improvement is sold within one year of com- - -- Canopy Type II ❑ • Zoning Approved ByI Date // I
.pr tie the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By - q./ Date �} /�J ty/�7
rove for the purpose of sale). •
I'� (}!/L.1S{/
I, as owner.of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Data
tractorsto construct the project (Section 7044,Business and Professions Code: -. _
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑o-100,000 BTU ❑100,000 BTU SU MARY OF FEES
•
builds or improves thereon,and•who contracts for such projects with a con- •
r^s - •
-
tractor(s) license pursuant to the Contractor's License Law). I am aware that BUILDING PERMIT $ .SV . SMIP $ o 50
proof oftheir Worker's Compensation insurance should be provided to me.. Exhaust System ❑ Multiple ❑ System Repair/Alteration - -
• • 27• 0003 PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. !CBO# Fire Dampers PLAN CHECK $ 7' O•G ISSUANCE - $
```"""'''""" n / ,1 _ PLUMBING $
)•,Daterail, ..GES Owner :/{r'/ r1 - .UNJ-�-� Heating System& Ducting Registers • PLAN CHECK 25% $ • 1. . C 0 ENERGY P.C. $.
I hereby certify that I have read this application and state that the above . 00-100,000 BTU 0100,00013T -ELECTRICAL - $ '`t� GRADING $
information is correct:I agree to Comply with all city and county ordinances -
and state laws relating to building construction, and hereby authorize repre- - PLAN CHECK 50%- $ Jr r MICROFILM $ . .
' sentatives of this city to enter u on the above-mentioned property for • •
inspection purpo /77 '-7 p
�. Signature It,tir' Datd4.l! s0 _ MECHANICAL $_ • TOTAL FEE $ / r in.--N
Drivers' License or 55# % f ' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
,CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - n
1 CONSTRUCTION AND PLANNING . • _; POOL &SPA _ - - '
•
APPROVALS Permit# Date Inspector APPROVALS Permit# Date . -Inspector
1V Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. '
�/�/0/f��ry 53. Steel Reinforcement t r
3. Electrical Conduit Utility-Undrgrnd. L 54. Forms '• -
4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding ' '
1,
5. Steel Reinforcement l ' 56. Rough Plumbing & Pressure Test •
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings LrE"Y 214187 ,0 A 58. Electrical Conduit-Undrgrnd.
8. Foundation „t‘ - -
59. Gas Pipe, 0 Undrgrnd., Test, -
9. Water PipeiUndrgrnd. -. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
/147 �4'
10. Structural Floor System .. ' !' Pe- 61. APPROVAL TO DECK • -: -
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final`, • .
•
12. Sewer Cap63. Heater & Vent-Final •• I- `-
13. Roof Drains ' 64. Plumbing System - Final t •
- 14. Rough Plumbing 65. Electrical-Final r
15. Rough Electrical-Conduit 66. Solar System-Final I • -
16. Rough Electric Wiring �a7 5% r ��t✓1 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 - 1-1.; kiFIRE DEPT. REQUIREMENT '-, ,
20. Rough FactoFireplace APPROVALS Permit# _ - '
ry
l
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 1-
25. Roof Sheathing i/�/�j 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat / /// 75. Dry Chemical - - ' -i e
' 27.'Frame and'Flashing �n y�jyr( Q- 76. Dry Standpipe • ;/ • -
28. Lathing & Siding ( ' 77. FIXED. SYSTEM FINAL - - -
29. Insulation !( 78. FIRE PREV. FINAL • � ,
30. Drywall Nailing 0 frfn OS HEALTH DEPT. REQUIREMENT •
-
31. Plaster Brown Coat / 79. FINAL INSPECTION -
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED' •• ' §
33. Final Electric - ta/l9Notes:
�,,R3 24,7, 37 72, s.ro,, ' •
34. Final Heating & Air Conditioning •
7 .: - s _- i ; -I ,0 4 a ttim-�
35. Final Gas Pipe-Test - et �e
/2-,�/-.F7 �%i,��,✓t,.� /1� .--�, ..yam.,,
36. Hood or Canopy
�J5* goa \erketa.l olt P",it Qcos f
37. Final Factory Fireplace - j c
0iff
(100 S��nQtay�38. Final Plumbing - Q /yZ���� ylv�cq/ SL,=.39..Water Service-Final -
40. Gas Service-Final -• ,
41. Solar Domestic-Final - - -
42. Backflow Preventer - - -
k
;. I_ ti,C. 'i
43. Backflow Irrigation . . -.
44. Landsdape Irrigation System - - ,1
45. Sound Attenuation - •'
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ; .0/n De • '
48..-Speciali Requirements Completed - r _ # F'
49. Electric Release to Edison - _ -
. _ei
•
50. Gas Release to Southern California Gas Co - _
/ 1!
51. CERTIFICATE OF OCCUPANCY / • •f'
,
No. Date • .. r '3( r / -
- ' ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT—. •
.. : PERMIT NO. p// TRACT NO. LOT NO. UNIT NO. •
' Project Address 2S /4149 y(/6Li4 3` 7 / ? � 11 rr'' • 2922 I /I.I /88 �505 TL
Applicant's Mailin�g�(dddLdreu //7'__i . ,.' TYPE OF CONSTRUCTION LJ NEW EJ ADD /ALTERATION U REPAIR
Owner's Name ./.+C-�r AIEA02 Phone5Yt /c(/ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q-p,# I Zone
./uE DESCRIPTION OF WORK/USE OF BLDG.
• S—A
me S Main Building: Accessory Building: - .
Arch/Eng. /Av License No. TYPE OF PERMIT C7 GRADING —rL1—/ 'bNDATlON IE STRUCTURAL E
Front • - 0
Address ❑ TENANT. ❑ ELECTRICAL LJ PLUMBING ❑ MECHANICAL • Bq Rear N
Contractor's Name Phone ❑ OTHER - -
PROJECT DESCRIPTION Sri. FT. OCCUPANCY C Right N
K G
Address(mailing) - CONSTRUCTION TYPE VALUATION$ S Left
City License No. ZONE GRADING CU.YDS. ' ACRESR
' LICENSED CONTRACTOR DECLARATION Ping. Ref. 4 Parking Req./Provided E
�1 Q
1 hereby affirm that I am licensed under provisions of Charter 9 (commencing ' Remarks: '- 1�� a. � L q0a n Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code,and ✓ T
' my license is in full force and effect. . ' $
License Class License No. .
Date Signature - • PLUMBING FEES-
WORKERS'COMPENSATION DECLARATION Bar Sink Showers - ELECTRICAL . FEES
•
I hereby affirm that I have a certificate of consent to self-insure or a certificate -
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink '
3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow Irrigation Sewer Cap. Construction Pole Sub. 050+KW '
' 8Certified copy is hereby furnished. - -
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps
Date Applicant -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers ' Solar Collectors • Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100)or —
less). Dishwasher Solar Piping Dryers. ❑Gas DElectric . Sub Panel •
I certify that in the performance of the work for which this permit is issued, I -
shall not employ any person in any manner so asome subject to the Drinking Fountains Solar Tank Fan ors❑0-1 HP ❑1'h-8
Workers' mp�rylation Laws of CaYfesml� /L/� - •
Date / j l Signature 1C r1�7 Floor Drains Swimming Pool w/Spa �— F.A.U. Inc.Solar 09-15 HP ❑16-15+
NOT( If,after making this declarltion, you s d become subject to the '
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • Urinal Fixtures Microwave
comply with such provisions or this permit Shall be deemed revoked. -
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet ' Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which termit is issued (Section 3097 Civ. C.) - _
Lender's Name y ry Interceptors Water Heater Outlets Range
-
Lender's Address / Kitchen Sink Water Service Switches •
OWNER BUILDER DECLARATION Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections •
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P—Trap / LaundryTrays Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit Y Generator ❑0.5 KW ❑5-15 KW
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law (chapter 9 (commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt • —
therefrom and the'basis for the alleged exemption. Any violation of Section
-7031.5 by any applicant for a permit subjects the applicant to, a civil
penalty of not more than five hundred dollars ($500).
I, as owner of the property 'or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered - ' Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's ' MECHANICAL - FEES -
License Law does not apply to an owner of a property who builds or improves _ -
thereon, and who does such work himself/herself or through his or her own - • DEVELOPMENT SERVICES REQUIREMENTS: -
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ _ '
sale- If, however, the building or improvement is sold within one year of com- Canopy ' Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
rove for the purpose of sale). _ Building Approved By Date
I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date La•
tractors to construct the project (Section 7044,Business and Professions-Code: -
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY O FEE
builds or improves thereon, and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that —Exhaust System ❑ Multiple ❑ stem Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK • $ PERMIT- •
J `
❑ I am exempt under Section B.& P. .for-this reason Firepl/Fact.Blt.ICBG 4 Fire Dampers �^
/ - PLUMBING' $ ek, ISSUANCE $
Date IOC., �'I
Ow , i Itsr Heating System&Ducting Registers • ENERGY P.C. $ '
PLAN CHECK 25% $
I hereb c'rtify that I have re.• this apps' . ion and ate-that t A&' ❑o-100,000 BTU ❑100,000BTL— ELECTRICAL $ GRADING $
information is correct. I agree t• comply with all city /d county ordinances
, and state laws relating to building construction, and hereby authorize repre- - MICROFILM $
sentatives of t to enter Lino)- • e above-mentioned pr per y for - . - PLAN CHECK 50% 1$ -
inspectio •r+r"" / •
• MECHANICAL $ TOTAL FEE $ J •co
Signature I _ �.s✓ eL Date G Q Reinspection Fee I $15 Issue Fee $ 3 - PLAN CHECK 25% $
Drivers' Li nse or SS
CMF 0865-46,rev. 10/84 - Applicant; Pink -Accounting; Goldenrod - Assessor
•
CONSTRUCTION AND PLANNING '- _ - POOL &SPA -
r Date Inspector Date . Inspector
'APPROVALS Permit # i iAPPROVALS Permit#
1: Temporary Electrica&;Service or Pole 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd, 153. Steel Reinforcement •
3. Electrical Conduit Utility-Undrgrnd. '
54. Foams
•
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement ! 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grrid.'. 1 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 62. Backwash & Receptor-Final
12. Sewer Cap63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing /r/a-g?,*A557 65. Electrical-Final •
15. Rough Electrical-Conduit , - 66. Solar System-Final -
16. Rough Electric Wiring - _ 67. Fencing & Access Approval
•
17. Rough Wiring Sign 6B. APPROVED FOR PLASTERING - • .
•
18. Rough Electrical-T Bar Ceiling !1 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
20. Rough Factory Fireplace APPROVALS Permit# -
21. Ducts, in Structure70. 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 ❑Gas ❑Oil •
25. Roof Sheathing 74. Overhead Hydro {.% •
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - -
27. Frame and Flashing76. Dry Standpipe TO
28. Lathing & Siding
77. FIXED SYSTEM FINAL I-1
29. Insulation , ' 78. FIRE PREV. FINAL i,t
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT ,,r;
31. Plaster Brown Coat 79. FINAL INSPECTION ' sr." ,
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED •
33. Final Electric • . .Notes: • r i
34. Final Heating & Air Conditioning
. 9
35. Final Gas Pipe-Test '
36. Hood or Canopy
4-
37. Final'.Factory Fireplace / Q r
38. Final Plumbing 5/174ns 4
39. Water'ervice-Final _//�"/ _
40. Gas Service-Final .
41. Solar Domestic-Final . - 'I '
• 42. Backflow Preventer
43..Backflow Irrigation . - - . '
44. Landscape Irrigation System , •. .r }, ,
45. Sound+Attenuation .f - {fir r
46. Handicap Regulations . i
47.•F I NAL STRUCTURE & BU I LDI NG . - - „ r '•
48! Special Requirements Completedi r
49: Electric Release to Edison -
50. Gas Release to Southern California Gas Co - - r
51. CERTIFICATE OF OCCUPANCY .
-
No. Date . _ .
PROJECT ADDRESS: 254 MAGNOLIA ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06524°
OWNER'S NAME: WEHR, BERT W
ADDRESS: WEHR, CHRISTINE L PERMIT NO: B 065245 PLAN CHECK NO: N GOVT: N SUPP : N
. 254 MAGNOLIA ST
' COSTA MESA, CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: STA PURPOSE: ALT
ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : T/OFF SHEATH 6 REROOF W/COMP SHINGLES SQ FT: 3, 200
ADDRESS: UNIT:
CLAIM VALUE: 3, 200 . 00 CALC—VALUE: 3 , 200 . 00 GROUP OCC : R-3 /M-1
PERMITTEE: BERT WEHR ( 714 ) 548-9190
ADDRESS: 254 MAGNOLIA ST COMMENTS : REROOF 1700SF RESID & GARAGE W/COMP, SMOKE DETECTORSTIT9 I3
1 C.M. CA 92627 • ***�r******B6x-**+r**ar*�c-*BteteE�686***�6*-�6*�E+ **i<*�6�te6+��c�c*r****�E�E*****�E6��yA-/�,$<�J a ,
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS J 37F
""FDX� � �
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS (/�
CITY LIC.: STATE LIC.: CLASS: R EQi V IRED
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 11721202 ZNE: REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES'> _
> r
Date: Applicant'. *********************************************************************')f*********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). D E V E.'L OPMENT SERVICES R E Q U I R E M E N :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 1
L_
subject to the Workers'�jCompensation Laws of California. ,x 46./.2.1„.
� ZONING APPROVED, BY DATE: 2-
\ Date: /? C/- C 7 _ Signature: v�.01... ' ti" :
7 NOTICE:II,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BYDATE: rP
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. /
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY : yi. DATE: 12'(e(9 1
which this permit is issued(Section 3097,Civ.C). ********************** ' • *• ***********py.7r**itiF'.'97F**
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION : N F E E SUMMARY STRUCTURAL SEGMENT : Y
OWNER BUILDER DECLARATION: I hereby affirm that I 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 6 3 . 0 0 5 Y
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 5 OP
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business i— SMIP/NON—R E S
and Professions Code)or that he/she is exempt Therefrom and the basis for the alleged exemption.Any violation of Section 7031,5 by PLANI'
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE • —i
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL f/ PAID '' DUE
El structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 63 . 50 0 , 00 0 . 00 6 3 . 50 63 . 50 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through J—
im or hermown employees,witin provided that mpl ion,the owner nle are note bd de oof pr for shed lf.einotand oipyr REVENUE D I V I S ION TOTAL S--> COLLECTED: 6 3 . 50 OVER/SHORT : `7
his hof n sp wieepre year of t such limp oveentwill have theen burden offered
proving ae/she did not howeverbuild or improvegr . 00
for the purpose ot 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 63 . 00 , 50_/ '—
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon t
and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law). lam aware ***********************************{p*****.)F*************,t.**jf', *St************.7F.**,**
That proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K D ,G W N /7❑ I am exempt under Section: B.Si P.C.
for this reason: - / / TYPE QTY DESCRIPTIO N UNIT COST -cTOTAL COST
n �
Date: l� i� /✓� owner r!N �'' -"feta-4- SFR 3200 REROOF BY VALUE RESIDENTIAL NOZONE - 3 , 200 . 00
I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES ;•$1i
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a i
permit lot construction or modification from the Alt Quality Management District.Residential construction applications are exempt from f'.
these provisions.
Date: Applicant: / '
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county �s r 1
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned I,
properly for inspection purposes. ��� i n
Date: /2 '- Signature: ''— /�'//�"'f'� 01 001`1^71$-00151919 TOT 63.50
DATE: 12/08/93 TIME: 08:44
Driver's License or Social Security
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
`r
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 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 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing& Access Approval
17. Rough Wiring Sign 1 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
r
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank OGas ❑Oil
25. Roof Sheathing �.z -9 G3 4'4/ /,( _ 74, Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat �V� 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL �{
29. Insulation 78. FIRE PREV, FINAL {I
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace •�+
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow irrigation / a- Iq_1 ? ria- , L `„eftbcey
44. Landscape Irriaatic'i ystem
f
45. Sound Attenuation,/
46. Handicap Regulations.
3
47. FINAL STRUCTI.LR IILDINGI/ 0 i- GL
sw. .�e /J2-
Dt B `L - ‘wfr
48. FINAL PLANNINl1 .,,.
49. Electric Release toirris •
50. Gas Release to Souih rr,, ifornia Gas Co
51. CERTIFICATE Of.0CCUPANCY
No. Date