HomeMy WebLinkAbout3050 HARBOR BLVD - Building Permits\
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.Aoo���ant to /ill in all spaces except those witnin heavy eorOer Ilnes antl si9n al1 approvriate Ceclantions.
CI7Y OF COSTA MES i CON TR UCTION P RMI
ProjectAddress � �6�� �"v
Applicant's Mailing Add e s 36Z� CpuN � // d
Owner's Nam�,�� O e o Phone
Address S �-�(}-/L�Ci� 'Q� V�
Arch/Eng. License No.
Address
Contractor'sNama��%-�����r''" �• S• oneS%I—�8'�4+
Addresslma'I' g) 36�-"� �nUN� ' '
Ciry License Nn, � 3�%�
UCENSED CONTRACTOR DECLARATION
I he�eby aHi�m that 1 am licensetl untler provisions of Charter 9(comme0cing
with sectiOn 7000) of Divizion 3 of th Businnss antl ProtG55ion5 Cotle, antl
my Iicense is in fuU t�ce antl�tfect. �. q�
LicenzE Cla 5 � ze No. �
Date Si9nature
WORKERS' COMPENSATION DEC ARATION
I hereby atfirm tha[ I have a certititate of consent lo selt-insure or a cerHfiwte
rt Workers' Compensation Insurance, or a certlfietl copY thereot (Sectlon
3800, Lab. C.) N, �j
PolicY No.�ZLID'LGCV�I�7yCo PanY �
Cer ietl copy is hereby furnishe0. �
i�tiflotl copy' e witn the city 9u ivision.
DateY —� D_� �� qpp�icant
EXEMPTION FROM WORKERS' COM NSATION DECLARATION
(This section neetl not be completetl If the permit Is for one huntlretl ($100) or
less).
I c¢r[ify lhat In tne pe�tormance of the work fOr wM1ich this pe�m�t is issuetl I
shall not amploy any person in any manner so as to become subject to t�e
Workers' Compensation Laws ot California.
Date Si9nature �
NOTICE: It, aRer making this tleclaration, you shoula Decome subject to the
Workers' CompensaHon pmvisions oi tbe Labor Cotle, you must (orthwith
comply with such provisions or Ihig permit snall be tleemea revoketl.
CONSTRUCTION LEPIDING AGENCV
1 hereby a�fl�m that there is a mn5(ructibn IenCing agenty for the pe�fo�manG¢
of the work for wniU this permit is Issuetl (Section 309� Civ. C.)
Lentler's Name
Lenaer's Atltlresz -
OWNER BUILOER �ECLARATION
I hereby af/irm that I am exempt frorq the Con[ractor's License Law for the
following reason (Section 7031.5 Busin¢ssantl ProfesslonabCotle: Any city or
County which requires a permit to construct, altCr, improve, tlemolish or repalr
any structure, prior to its issuance, a1s0 requires the appliwnt for such pormit
to file a slgnBtl statement thaf he/she i6 licensetl pursuant to the provisions Of
the Contractor'S License law (Chapter q(comm0ncing with Sectlon 7000) of
7ivision 3 of [he Business antl Pro/¢ssions Cotl¢) o� that he/she is ezemp[
ieretrom antl the basis for the alle9etl exemption. Any violation o( Sectlon
031.5 by any applicant for d Pertrylt 5u0jects the ap011canl to a Civll
�e�dlty of n0[ more Ihan fiv¢ huntl�etl tlolla�s (E500).
I, as owner of the prope�ly or my emplOyees wi�h wages as their sole
compen5alion, will tlo the wo�k, antl the slrUctu�e IS not Intentletl o� ofter¢tl
f0� Sdb ($OCLI00 i0<4. BU51l1255 dOd p�01B55�00d1 COtle: ThB COfllfdC101'S
License Law tloez mt aDP�Y to an owngr oi a property who builtls or improvas
th¢reon, antl who tloez such work hlrt�selt/herseli or through his ot her own
employee5, provitletl tha[ such iTProv@m<nts are nOt intentled o� oftere0 �o�
'� sale. It, however, t�e builtlin9 or imOrq�ement is soltl witnin one year oi com-
pletiOn, Ihe Owner will have the burtlep Of proving h¢/she tlitl nOt builtl or Im-
�/Ove for Ihe purpose ot Sale).
I, a5 Owne� of tM1e ptoperty, am ¢zGlusiv¢ly conttactinq wi[h licensed Con-
cractors to construcl the projecc (Sectio� �044, Business antl Protessions Cotle:
The Contractor•s License Law tloe5 nbt apply to an owner of proper[y who
builtls o� improves Mereon, antl wno Contracts tOr SucM1 p�oject5 wrtn a con-
tractor�s i�cense pursuanl to the Contractor's Liconse Law). I am aware tnat
prooi o� their Worker's Compensation insurance shoultl be providetl to me.
❑.1 am exempt untler Section — B. & P. C. for this reason
Date
in5pettion purposes.
Si9naturG
Drivers' Licans¢ or 5 �
upoh
Date� ]�� ��J
F' 3 z, z-4 l�: _
TVPE OFCONSTRUCTION ' NEW�-�� ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH LTOTHER - q.p.#
DESCRIPT14NOFWORK/USEOFBLDG. F�r'� ��Ari ��✓'
�, -�� � � S Main Buildi
� s
TVPE O�RMIT GRADING FOVNDATION STRVCTURAL T Front
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Real
❑ OTHER - � C Right
PROJECT DESCRIPTION Sq.FT, oCCUPANCY K
CONSTRUCTIONTYPE VALUATION$ ��� Left
ZONE GRADING CU. VDS. ACRES p�ng. R2f. #
Remarks: �%( ,� I� y_ /..�Q, 9,S^ (.A , d+� ���O�$$ LY// Planning Notes:
PLUMBING
Sink Showers
cflow Preventer Service Sink
<flove Irriqation . Sewer Cap
nubs � Sewer Connec
ifiers � Solar Collectors
iwdsher Solar Piping
Drinking Fountains ,
Floor Drains '
Floar Sinks
Gas Service Outlets
Interceptors � /
Kitchen Sink '
lavarories
P—Trap
Roof Drains
Reinspection Fee
Solar ank
�mming Pool w/5
Urinal
Wacer Closet
� Water Heacer
Water Service
Auto-Wash
Laundry Trays -
$15 Issue Fee
Boiler
Dutt-UnderGround
Duct - Sttuctural
Duct - Ventilating
Exhaust System ❑ Mul[iple ❑
FirepUFact. BIL ICBO #
Heating System & Ducting �e
❑6100,000 BTU 0100,OOOBT
Reinspection Fee � 515
CfJIF�0865-46, rev. 30/B4 White - Builtling; Canary - APPlicant; Pink - Accounting; GolUenrotl - Assessor
Hood or Typel �
Canopy Type II �
Refrigeration System
Oaiao,000a ❑ioo,000
SVste epaidAlteration
ire Dampers
Re9isters
laue Fee
FEES
5370 2/I'8/80
Zone_
Parking Req./Provided
ELECTRICAL -. _
P.utomatic Washer Transformer ❑ 15�50 KW
ConstructionPoleSub. . �SO+KW -
Cooking Unit .� Meter ❑up to 100 amps, ,
Dishwasher Meter ❑over100amps
Dryers ❑Gas ❑Elecvic
Fan
F.q,U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator DO-5 KW �5�15 KW
Sub P
M�rs �0-t HP �1'f. - 8
)
InaSolar �9-75 HP �1E75+
Microwave
Pole Light
Sign
Standing Sections
Trash Compactor
$ 3 I
� Reinspection Fee $15 Issue Fae
FEES
�DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By
6uilding Approvad By
Appliqtion luuad BY �—� � �
5 3
BUILDINGPERMIT $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $
MECHANICAL $
PIAN CHECK 25% $
63053 Tl
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G
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M
T
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FEES
$ 3
FE� .S�
SMIP $
PERMIT
I$$UANCE $
ENERGV P.C. $
GRADING 5
MICROFILM $
TOTALFEE $ �•�3
'C�ONSTRUCTION AND PLANNING , POOI & SPA
"+ Date �Inspector Date Inspector
QPPROVALS . Permit # APPROVALS Permit #
1: yTemporary 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 ConduibUndrgrnd. �
8. Foundation �� � 59. Gas Pipe, O Undrgrnd., Test .
9. Water Pipe-Undrgrnd� . � 60. Backwash Lines, P-Trap, � Undrgmd. �
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line!& House Connection 62. Backwash & Receptor-final �
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. �Plumbing System - Final � �
14. Rough Plumbing . 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval �
17. Rough Wiring Sign . 68. APPROVED FOR PLASTER�NG {,
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL' �
19. Rough Heating & Air Conditioning F,I�RE DEPT. REQUIREMENT 1.
E/ '
20. Rough Factory Fireplace APPRONALS �Permit # ' �
21. Ducts, in Structure � �„� 70.�Underground Hyiiro � .
22. Ducts,Ventilating 7 gProduc�;tPiping�Gas ❑Oil
��� ,
23. Gas Pipe-Rough & Test 72. Under�und Flush
24. Roof Framing. 73,
25. Roof Sheathing � � . . 7q: 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 E PREV _.__ -.
30. Drywall Nailing HEALTH DEPT. R,EQUIREMENT ' �
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 ' ,
i:
35. Final Gas Pipe-Test � �
36. Hood or Canopy ,
37. Final Factory Fireplace , � � ,
38. Final Plumbing ' '
39. Water Service-Final • •
40. Gas Service-Final � � y " �
41. Solar pomestic-Final �
42. Backflow Preventer , . � - , .
43. Backflow Irrigation .
44. l.andscape Irrigation System . ' - � '
45. Sound Attenuation � �
1
46. Handicap Regulations ' � . �';;,
; 47. FINAL STRUCTURE & BUILDING • �
48. Special Requirements Completed � -
!
49. Electric Release to Edison � .
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY . . .
No. Date
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