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HomeMy WebLinkAbout1217 LAS ARENAS WAY - Building Permits ADDRESS a FURLONG 1217 LAS ARENAS WY UM' CITY OF COSTA MESA — BUILDING PERMIT =NER'SNAMEIEI0lO*? DAN SHINNER PERM NO: B 079322 ADDRESS 1217 LAS ARENAS WAY COSTA MESA PERMIT NO: B 079322 PLAN CHECK NO: N GOVT: N SUPP : N CA 92627 APDL,MARINO ADDRESS CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: REP ARCHITECT ORDOWER: ucNO_ JOB DESCRIPTION : REPAIR DRY ROTTED EXTERIOR DECK JOISTS SQ FT: 1 , 500 ARCH,OR E/KL'S ADDRESS: WIT: CLAIM VALUE: 1, 500 . 00 CALC—VALUE: 1 , 500 .00 GROUP OCC: R-3 / cU1WACTarskIME MACK CONSTRUCTION ( 714 ) 568-7744 CONTRACTORSMNUNO 1357 FREMONT ST COMMENTS: REPAIR WATER DAMAGED JOISTS ON 2ND FLOOR DECKeNICI ( Fie Lpip ADDRESS ANAHEIM CA unto, 659507 *******************************************************o1NlAAFF *�ke'99tc+++Ne^`l>lt4EAF* E'*+F"it 92804 WIT: ZONING REQUIREMENTS REQUIRED LICENSED CONTRACTORS DECLARATION:I hereby affirm under Ninny of • ry that I am licensed under provisions ol Chapter 9 S E T B A C K Jr (co nmerwng with Section 7000)of Division 3 d the Business and Pamy ken"bin fun 1 ow. crrYuc.Nero.: 058300 LIC,CUSS: B UC. 5d 9607_03 /97 MAIN BUILDING ACCESSORY BUILDING q �//( _� FRNT: FT IN REAR: IN RGHT: FT IN FRNT: FT IN REAR: FT IN Der )5 -7- I --94 Contractor:Contractor:Contractor: LEFT: FT FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I em exempt from the Contractors License Law for the following reason(Section 7001,5 Bushes,and Professions Code:Any city or county with requires a permit to°mama.akar,improve, PARKING REQ: PRO V: PARCEL : 93633009 Z NE: REF NO: demolish,re repo any smcaule,prior to its issuance,abo requires the applicant for such permit to fib a signed statement that he or she is licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commending with Section 7000)of Dwbbn 3 of the PLANNING NOTES> . Business and Professions Codej or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section > ,..- 7,201.5 7031.5 by any applicant tor a permit subjects theaPpoant to a civil Lenny dnot more than live hundred do4n(S50Oj). ********************************************************************•1E********** ❑ I.as owner el the property or my employees with wages as thei sole compensation.will do the vork.and thestructureisnakneded D E V E L O. P M E N T SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Contractors Licensee Law does not apply to an inner of progeny who bolds or improves thereon.and eta does such work himself er hang or though his or her own emplosses.Prodded that such improvements ore not intended ooffered for sale.lf,however.the building or improvement is sold within one year of compssn,the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or She did nor beide or improve for the Puryoee of sale). ❑ I.es owner of the prepay,an exclusively contracting with licensed connectors to construct the Mien(Seton TON,Business ed Professore Code:The Contractors License Law does notappy to an owner d progeny w o builds or improves thereon end wBUILDING APPROVED B Y : DATE: contracts kr such projects with a mureta(s)licensed pursuant to the Contractors License Law). ❑ Iern exempt under Section: B.a P.C.,for this reason: APPLICATION ISSUED BY: DATE: 1 -11 ************************ * ** ** *************** ** . 2.* Des: OwnerLEGALIZATION:N F E E S U M M A Y STRUCTURAL SEGMENT:Y I do hereby mealy that I am aware d and understand the requirements ol California hleekh and Sauey Code Senlons 25505,25533,and • 25531,end tat I or any More building occupant,am ananawill/willno(circle one)need to comply wth said mats codes and the requirements for e permit for construction ormodd melon from the Algement District.Reskernial°narudcneppkations ere from thew BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 48 . 50 . 50 Dae: Applicant: ,; SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of nsfollowing oof the dedaetims: PLAN ISSUE x ❑ BUILDING-DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE have and will maintain a certificate d convent to selfinwre ler workers comwnWon,n provided la by Seniors 3TIX1 d IM labor Code,It the performance of the work for which this gem etssud. TOTALS----> 49 . 00 0 . 00 0 . 00 49 . 00 49 . 00 .00 ❑ I have and will maintain workers'°mpenasine insurance.as required by Section 3700 of the Labor Code,for the performance d the work for which this permit a issued.My workers'compensation insurance carrier end policy number are: Carrier: REVENUE DIVISION TOTALS > COLLECTED : 49 . 00 OVER/SHORT:• 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (ihla need naw°mdardAlMperms bro.omnedwdew/anfst orlwe.l 48 . 50 * . 50 candy that in the performance d the work for which this permit is les shell not employ any person in any manner so as to became'send m en to the workers'compensation lees d CeMomo, agree .,bjesubject to the workers' *** ************************************** ************************************* compefus eddionprovand gn3700dtheLaCods n pry with INDIVIDUAL FE. a BREAKDOWN Dae: b ...Lc, 6, Applicant: Wlming:Fliun to secure workers'C enssUon coverages unlawful,andshdl subject an employer to cdnsnal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(4100,000),M addition to the cost of comPanee on,damages as Provided ler in Sectlon 3105 of MS Labor Cods,Interest,end attorney's fees. SFR 1500 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 500 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally el perjury that there is a aMnidian landing agency for the END OF FEES perform-este of the work for whits this permit is issued(S460113091,Cie C). LENDER'S NAME: LENDER'S ADDRESS: v I certify that l have read this application end state that the above information is coned.I agree to comply with all thy and county ordinances r and statsip to braiding°nstmdion end authorizerep hereby asentatbcityes of this city enter upon the above-mentionedpopery Iceins• ' prove°. e rrj.c k— rintName g-sir-Ia A . A /� .a Date: Signature of Wier/Agent/Appk anUContector (515140.WP) White-Buildip A Salary;Green- e;Casty-pppjcant;Pink-Revenue;Goldenrod-Assessor • JJ CONSTRUCTION AND PLANNING POOL a SPA , AP,PROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ) 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement y 3"Electrical Conduit Utility-Undrgrrid. 54. Forms -4. Electrical Conduit-Uridrgrnd. - 55. Electrical Bonding .. - 1 5: Steel Reinforcement-, 56. Rough Plumbing & Pressure Test •- ; 6. Electrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE • T. Footings ' 58. Electrical Conduit-Undrgrnd. 8: Foundation -,r 59. Gas Pipe, O Undrgrnd.,Test • ' 9: Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, Q Undrgrnd. 10..Structural Floor System . - 61. APPROVAL TO DECK/'I ' 11. Property Sewer Line & H&use Connection 62. Backwash & Receptor-Final<t 12. Sewer Cap 63. Heater & Vent-Final .. 13. Roof Drains - 64. Plumbing System - Final . 14. Rough Plumbing . _ 65. Electrical-Final i 15. Rough Electrical-Conduit 66. Solar System-Final I ` 16. Rough Electric Wiring 67. Fencing & Access Approval - 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electricat•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.:Undergrdund Hydro 22. Ducts, Ventilating'- : , r • r .• , 71• Product Piping O_Gas 0 Oil 23.'Gas Pipe-Rough & Test _ ` '' ^7 r - 72. Underground Flush„ _ _ - 24. .Roof Framing - - _ - - 73. Undergrnd.Storage Tank O Gas O Oii 25. Roof Sheathing 4, - _ _ . . 74 Overhead Hydro- ' 26. T-Bar Ceiling (Structural) & Monocoat . _ 75'. Dry Chemical - _ 27. Frame and Flashing ;Wi6 _A- //_ 76. Dry Standpipe, c- - • 28. Lathing& Siding - _ • . - - .• - 77. FIXED-SYSTEM FINAL - 29. Insulation - 78, FIRE PREV. FINAL - • 30. Drywall Nailing •` '+ J-IEALTH DEBT:REQUIREMENT 31. Plaster Brown-Coat _ - " i r 79. FINAL INSPECT ° ION '- 32. Electrical Power Meter final rr 80. FOOD CERTIF1,CATE ISSUED r _y 33. Final Electric Cr r 1? '- Notes: 4 K -- 1 34. .Final Heating'& Air Conditioning - 1': tlossfewia"s- i i)fro � :40-iti/ i,< ide 35. Finai•Gas-Pipe•Test ' _ _r • COP&eiCAlcie-. ft $ 1 /r J = _ 36. iiooa•or Canopy - - , - . . J ' - 37. Final.Factory Fireplace- - - +' • - -- 38. Final Plumbing -_ 39. Water Service-Fina) - x _ - -- - _ _ 40. Gas Service-Final , . - ' '- •- 41.41. Solar Domestic-Final _ • • _ _ - - .•C. - :. 42. Backflovu Preventer - - ., ' . r, - 43. Backflow Irrigation- - _ - - - 44. Landscape Irrigation System-, - _ 45. Sound Attenuation - - 46. Handicap Regulations -.. - 7 _ 47. FINAL STRUCTURE & BUILDING C/L 914 48. FINAL PLANNING t/ - - 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co - _ 51. CERTIFICATE OF OCCUPANCY - - . No. Date • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - - e• - - . - 0aiikif CI.TY'bF COSTA MESA CONSTR jIO PERMIT "PERMIT NO. e. :TRACT NO.€.49LOT NO. 'P1NIT,.NO. Z( - Prolect Address I -ia-s �U _ S • '�-% I�q13 i z3 " , - I Applicant's Mailing Address TYPE OF CONSTRUCTION U NEW ❑ ADO H ALTERATION H REPAIR - /IILL '✓�¢�fT ISS Phone CONVERSION ❑ DEMOLISH ❑ OTHER • - A.P. # ^.- _ .Zone ' Owner's Name DESCRIPTION OF WORK/USE OF BLDG. ) `',''� t r e. , Address 12-17 4-iZi p-5 /r• ��-'-�Il - S Main Building: ' rptj ,,�Y -/•_� /accessto_y Building: Arch/En . .1kCAS ail -fi.Lv la C-1 z4ro3 TYPE OF PERMIT LJ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front I Of t O Arch/Eng.r License No. ❑ TENANT ® ELECTRICAL I�Y lI PLUMBING MECHANICAL B Rear !' L N Address 1£+Z2(o W1c- nC�2vY1�7T SZ✓Inl('L� 'F" ��' Ju�, 1 ^ 1J8 �I7T-�GOI ❑ -OTHER ' A. I Contractor's Name!XG�IS fir P-bi"rr.rs Phone - C Right \ N Address(mailing) /r ZZfv Vine-b,wse-rr' PROJECT DESCRIPTION SQ. FT. - OGC UPANCY K.. - - CONSTRUCTION TYPE VALUATION ' t Left fury Qn C i^ G CityLicense No. - 290 S3 - S rill ) l:7 l.��l.,r4 r+Ii:jA -R .. •ZONE GRADING CU.YDS. ACRES (� LICENSED CONTRACTOR DECLARATION Ping. R¢f.# Paf king Req/Provided - E +yl^�\"1( hereby affirm that am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: i°1�� M with section 7000) of Division 3 of the Business and Professions Code, and my license is in full�fj�}/�rce and effect. 11 /'��^�1 c5 - T Luanne Class •`. License�No.-4092-C> ( `J �`J !I $ Date '7-17'9 S' Signature r -k4`-�-- - PLUMBING FEES • 'N.3, WORKERS' COMPENSATION DECLARATION Bar Sink t Showers 7"/ AQ/Lan n. Z I hereby affirm that I have a certificate of consent to self-insure or a certificate / r^"fr�...^-,c-/4 ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KW Icy No. /+ZSQ E14-CebC Company ST04T6 'I=Unktp Backflow Irrigation Sewer Cap' Construction Pole Sub.- • 0 50+ KW Certified copy is hereby furnished.Certified copy is filed with the city(Boifdfng Divjsi n. V Bathtubs hte u'IQn tQ/ t Sewer Connection 'jam(0 Cooking Unit Meter 0 u to 100 amps Date 7`17-5 Applicant �L--r Wim+-- ' "-�'^"" EXEMPTION FROM WORKERS'COMPENSATION DEC: RATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one undred ($100) or ' less). - Dishwasher i Solar Piping Dryers DGas DElectric ' Sub Panel I certify that in the performance of the work for which this permit is issued, I - C. shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan \ Motors-KO-1 HP D%- 1 I 5DWorkers' Compensation Laws of California. lTl5/ Date Signature Floor Drains Swimming Pool w/Spa F.A.U. InSolar 09-15 HP ❑16- + NOTICE: If,after making this declaration, you should become subject to the - • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - - Fixtures comply with such provisions or this permit shall be deemed revoked. -IZxtures aMicrowave Z(pC 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 this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name Lender's Address 1 Kitchen Sink n�Qpt(e4 n+ - Water Service Z,(Y• `j i'Switches Sign OWNER BUILDER DECLARATION _ --""'vim g I �U I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories ' Auto-Wash ' • following reason (Section 7031.5 Business and Professional Code: Any city or _ Garbage Disposal $Landing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays - . " any structure, prior to its issuance, also requires the applicant for such permit Generator ❑0-5 KW ❑5-15 KW Trash Compactor 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 r •- . therefrom and the basis for the alleged exemption. Any violation of Section - .. 7031.5 by any .applicant for a permit subjects the applicant to al civil • ' penalty of not more than five hundred dollars($500). I LJ I, as owner of the property nor 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 I FEES . License Law does not apply to an owner of a property who builds or improves __ ' --7- -. , , thereon, and who does such work himself/herself or through his or her own - Boiler � Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements arc not intended or offered foryp -" Zoning Approved By Date sale. If, however, the building.or improvement is sold within one year of com- ' Canopy Type II ❑ - pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground - •7 Building Approved By Date prove for the purpose of sale). . IDI I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By - 1 Dat• - 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 OF FEES builds or improves thereon,and who contracts for such prolects.wlth a con- - ' tractor(s) license pursuant to the Contractor's License Law). I am aware that _ Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMTP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ q-00 ISSUANCE $ • Date s Owner Heating System& Ducting , Registers COENERGY P.C. $ I PLAN CHECK 25% $' I. Sn ' I hereby certify that I have read this application-and state that the above I 1$D-100,000-BTU 0100,000 BTL -- 4 «� ELECTRICAL $ �-�� GRADING $ information Is correct. I agree to comply with all city and county ordinances and state laws r lating to buildi g construction,and hereby authorize repre- PLAN CHECK 50% $, Z'N' MICROFILM $ sentatives o city to eryl upon the above-mentioned property for inspectlonRu op--6 ,,,�/ I '' MECHANICAL $ 42,.60 • - , TOTAL FEE $ a)•(0 Signature �,f.,�� Wu"lSti� bate �-1 7�aS Drivers' License or SS q/ + 7 I Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ I • 25- CMF 0865-46,rev.10/84 White - Building; Canary - Applicant: Pink -Accounting; Goldenrod - Assessor �' 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 ConduitiUtllity-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. , H. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test 1 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 ISt/C.0 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18.,Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - _ 21.:Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24; Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation - 78. FIRE PREV. 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:74 i�/�S A-C,a,Gc-D 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 44. ,Landscape Irrigation System '45. Sound Attenuation - 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 • • - • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ _ 7793 '7/3 /, _ _ • CITY OF COSTA MESA �CONST/R�CONSTRUCTION PERMIT - 'PERMIT NO. / TRACT NO. LOT NO. , UNIT NO• . - ' I �J 1 9y(IU TI Project Address (all LAC, -A[6jJ A5 � /' 9/3 1 � 11 $ I Applicant's Mailing Address - TYPE OF.CONSTRUCTION L•I NEW U ADO U ALTERATION Li REPAIR ' � �� '2S7 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p " Zone _ Owner's Name 'SI Li, I'��/i�V7`s�5 Phone�v_�.r..__t.__P-f� DESCRIPTION OF,WORK/USE OF BLDG. _ Address . \ 2$ 1 L/ '7 ./se a`5 l't S tlO \ - - i S Main Building: Accessory Building: • Z Arch/Eng. 1. E: . License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION U STRUCTURAL T Front - , . O Address Ai `1 1• •ice 51'J�,,.11,// 0 / V "�,s ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear - N Contractor's Name : 4t9w1e• - I Phone 474- OW'F-v ❑ 'OTHER A C Right N Address(mailing) - PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G \� - CONSTRUCTION TYPE ' VALUATION $ s Left City License No. ZONE GRADING CU.YDS. ' ACRES . . E LICENSED CONTRACTOR DECLARATION r Ping. Ref.'*• Parking Req./Provided - I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: pnr / 9'c5 ) c Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and �O� / • T my license is in full force ant effect 4 - 1 License s Lice, No. IQ-1270 - - Date //ja . • Signature !-. - �- - - se PLUMBING FEES WORK RS COMPENSATION DECLARATIO O -(IS 1.S ' e' I hereby affirm that I have a certificate of Consent to self-insure or a certificate Bar Sink • Showers ELECTRICAL , FEES 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. ❑ 50+KW Certified copy is hereby furnished. Cer f c PJ' fled with the cit B1y`iiding etp 1. Bathtubs Sewer Connection CookingUnit Meter ❑up to 100 amps e / •J a ApplicantY-..1 Ito--4_Y'W`� / V,p•r7 • EXEMP IO FROM WORKERS'COMPENSATI N DECLARATION....•`V Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or - 1 - less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric 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 as to become subject to the Drinking Fountains Solar Tank Fan Motors 001 HP 011/2-8 ' Workers' Compensation Laws of California. - Date Signature - Floor DrainsSwimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+ NOTICE: It,after making this declaration, you should 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 this permit is issued (Section 3097 Civ. C.) Lender's Name ' Interceptors Water Heater x• Outlets Range Lender's Address Kitchen Sink- Water Service 1 ' ,' Switches Sign OWNER BUILDER DECLARATION ' 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 - Laundry Trays 1 ,. Generator 00-5 KW 05.15 KW ,Trash Compator -any structure, prior to Its issuance, also requires the applicant for such permit 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 Denalty of not more than five hundred dollars($500). • I, as owner of the property or my employees with wages as their sole Issue Fee $ 3f *'compensation, will do the work, and the structure is not intended or offered Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor'sLicense 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 _ . • ENTS: employees• provided that such improvements are not Intended or offered for Hood or Type I ❑sale. If, however• the building or Improvement Is sold within one year of corn- Canopy Type II ❑ ning Approved By - Date pletion, the owner will have the burden of proving he/she did not build or im- !Exhaust ilding Approved By Date UIrove for the purpose of sale). �/t./1', I, as owner of the property, am exclusively contracting with licensed con- • Refrigeration System , • Application Issued By der-C--2 Date JY Ov 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 • ❑D-100,000 BTU ❑100,000 BTU - SUMMARY OF FEES builds or'Improves thereon,and _who contracts for such projects with a con- tractor(s) license pursuant to the Contra<tor'i License Law). I am aware thatBUILDING PERMIT' $ SMIP $ Proof of their Worker's Compensation insurance should be provided to me. System ❑ Multiple ❑ System Repair/Alteration • PLAN CHECK $, PERMIT ❑ I am exempt under Section B.6 P.C.for this reason Firepl/Fact.BIL ICBG 4 Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above - ❑O-100,000 BTU 0100,000 BTU - - - I ELECTRICAL $ GRADING $ Information is correct. I agree to comply with all city and county ordinances - . ' and state law relating to building construction, and hereby authorize repre- - + . MICROFILM $ sentatives of this city to enter upo t(e above-mentioned propert for PLAN CHECK 50% $' _ Inspection Pu oses. �1I .r'i'ICXI<vS I C• °n MECHANICAL $ TOTAL FEE $ /-S--Cie Signature • � ` �/�S/ Reinspection Fee $15 Issue Fee , $ 3 PLAN CHECK 25% $ l CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor . • POOL&SPA • CONSTRUCTION AND PLANNING 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, ❑ 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 68. APPROVED FOR PLASTERING 18. .Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19.:Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED %jy�L � 33. Final Electric Notes: /_ '7, P7 ,/ //�£- edzia 34. Final Heating & Air Conditioning -fors' j i/ yN Od',�A/ 2t 35. Final Gas Pipe-Test (6/f L//tel�dGY� 7/�' 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'PreventerI 43. Backflow,Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation 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 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA P MIT O. TRACT NO. LOT NO. BLDG. . • CONSTRUCTION PERMIT beNNI i' - Sa /0023 I �� 9.051 6_/22/8• _2 • 17_.00 TL Project Address o /y/ G,¢s oy�✓a s 4,..-/4-7 TYPE OF CONSTRUCTION Owner N/LL A-$E.,41‘...5 Phone en Zny 0 NEW 0 ADD ALTERATION Address ll(7 c.HS 4C-Ew/*S � / ❑ REPAIR 0 CONVERSION ❑DEMOLISH Arch/Eng. tot-c /vU L/ Pf2CIFB4sO9S 5903 0 OTHER /ZONING REGULATIONSc Address DESCRIPTION OF WORK_.d�� ur/,,s- -/ A.P.# ''.S(p — ��� S_ee, it 51.- W _ ZONE Z— PLNG. REF. Contractor K c S)`(ypE/z Phone$57-cy3/ TYPE OF PERMIT - • BUILD NG �'fr B I �v LI E pSETBACK C/L ST. OP .!1 - Address /gyp /3°K 203 /3fl ,srfl-tSa--n-o 0 GRADING 0 FOUNDATION WGTRUCTURAL SIDE YARD LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICAL LS IIDEE YARD - I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHTNal mencing with section 7000) of Division 3 of the Business and 0 OTHER v Professions Code, pa and my license is in full force and effect. REAR YARD(T P/L) License Class_6� d�Llcens u/x�'j 9-S—i3 PROJECT DE�SC)RIPTION y� r (.� SQ.FT. !`"- PKG.SPACE REQ. PROVIDED Date K 6"-2-2--n-Signature � •- WORKERS'COMPENSATION DECLARATION OCCUPANCY Ie- CONSTRUCTION TYPE �q STREET WIDTH PARK FEE$ I hereby affirm that I have a certificate of consent to self-insure or a ZOO �f ZONING APPROVED BV DATE�� certificate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE Q2 �� c--/ Z�/EaZ thereof(Section 3800,Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: / Policy No. - -- Company - - ❑ Certified copy is hereby furnished. REMARKS: ❑ Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - (This section need not be completed if the permit is for one hundred ($100) or less). ' I certify that in the performance of the work for which this permit'Is issued, I shall not employ any perso in ny man er as to become PLUMBING - PLAN CHECK ' ' ELECTRICAL PLAN CHECK subject to/the, or ers'Compensatio s of C • GE I Date `e C.. Z-B-& 2_ Signature � b BATHTUBS SHOWERS INV SO.FT CO FTGARA NOTICE: If after making this declaration, you should become subject ;TOILETS ;, URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE -10-50 KW 50+ KW revoked. - _ CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP_1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC.SOLAR) 10-50 HP 50+ HP . formance of the work for which this permit is issued (Section 3097 • - Civ. C:). - - - Lender's Name �1..lJ�F FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES • Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS - OWNER BUILDER DECLARATION - - INTERCEPTORS 'CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for the following•reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNSI HUL I ION Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE - ALTERATION PANELS MAIN SUB . quires the ap:licant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law - GAS SERVICE - OUTLETS • - SERVICE - - ' AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS • BTU OUTPUT - - basis for the alleged exemption. Any violation of Section 7031.5 by . any applicant-for a permit subjects the applicant to a-civil penalty SEWER CONNECTIONS - of not more than five hundred dollars ($500). ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - sole compensation, will do the work,and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. • ISSUE FEE - Z Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY - fit" DAT F� '� 8 who builds or improves thereon, and who does such work himself or ISSUE FEE - through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden 0.5-0of proving he did not build or improve for the"purpose of sale). BUILDING ❑ I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT E `� SM1P $ AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ • PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts-from such projects-with a contractor(s) Ilcesned pursuant to SYSTEM . GRADING $ the Contractor's License Law). 100,000-.BTU PLAN CHECK $ ❑ I'am exempt under Section B.& P.C.for this BOILERS BTV ELECTRICAL $ $ reason - PLAN CHECK E MICROFILM $ - Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE E I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ AD- information is correct. I agree to comply with all cityand countyPLAN CHECK $ VANESS E PC pY VANCE PC E_ • ordinarepres nta and t to laws REPrelatingconstruction,o en[ r upon the above lr mentioned /7.DO property f • edtion es. h 2Z8Z FINAL FEE 5 Signature Date Drivers' License or SS ISSUE FEE . CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNI G •t POOL&SPA APPROVALS Permit#-n- Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole - , - 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn _ 44. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrn 45. Forms • 4.. Electrical Conduit-Undrgrn - 46. Electrical Bonding - - - • 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical.UF,ER Grn t. - 48. APPROVAL TO COVER-GUNITE 7. Footings ,_ . . 49. Electrical Conduit-Undrqrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9.. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap; D Undrgrn ' - - 10. Structural Floor System 52. APPROVAL TO DECK - 11.- Property Sewer Line & House Connection - 53. -Backwash & Receptor-Final • 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55 Plumbing Syctem -Final 14. Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating &Air Conditioning - . 58. Fencing &Access Approval 17. Ducts, in Structure - _ 59. APPROVED FOR PLASTERING . , 18. Ducts, Ventilating , • 19. Gas Pipe-Rough &Test - - 60. POOL/SPA SYSTEMS FINAL • • 20. Roof Framing - - ' 21. Roof Sheathing 22. Frame and Flashing . - NOTES: G-as 7;,� li-9'"1 23: Insulation - - - - - 24. Lathing & Siding 4-.--.3S-g-1 , _13141 - _ - . . - - .- 25. Drywall Nailing - - 26. Plaster Brown Coat - .. 27. Electrical Power Meter-Final • -. - 28. Final Electric - - - - 29. Final Heating & Air Conditioning = . 30. Final Gas Pipe-Test - - - - 31. Final Plumbing - - 32. Water Service-Final . • - ' '33. Gas Service-Final .34. Solar Domestic-Final 35. Landscape Sprinkling System • _ 36. Sound Attenuation - - - . . 37. Handicap Regulations - - 38. FINAL STRUCTURE & BUILDING 6-1S-$a. 5 71 _ 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. . 42. CERTIFICATE OF OCCUPANCY I _ No. Date - 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. �r - PE MIT NO. TR e •- LOT NO. UNIT . . - 6560 -- 1/ 12/U'D- .,yn-._. -" T., 'CITYhF.COSTA MESA CONSTRUCTION PERMITA - I J/g7� /� —.— _ I . ' - ' , Project Adtress '2- 7 £TS 4aG)s/A5 1(/ t i . 1 1F53 � ` ' I . v f^ • TYPE OF CONSTRUCTION /L ,,,IPA'DD AL ON H REPAIR -Applicant's khjoiling Address �,} �l - J/ -z /v[fzI"tC.� ' Phone ' CI CONVERSION ❑-DEMOLISH CI OT E• q,p•#, ) �rQ,1 Zone Ka_ Owner's Name'. ',/ - DESCRIPTION OF W•RK/ SE OF B DG. ���1-. - — �t 'tea /K /7/7 4A5 A'IZF/I/ � 4447S Main Building: Accessory Building: Address ! ( - ` we .... . -u-) .s _ �,p 1. :Arch/Eng. r✓!�/P,�, E. - fF lira. se No,C--at - TYPE OF PERMIT IliGRADING II FOUNDATION G STRUCTURAL - T Front Address •• - VP /2N t/// IT '� ❑ TENANT ❑ ELECTRICL ❑ PLUMBING ❑ MECHANICAL B' ear> ----_--- ,I ❑ OTHER A L%Contractors Name �wC'+�.'�-ssa P one 47`1'0�/ ER • ' C Right ,-N C)T N • I - �"f - - l c ' - SrPROJECT DESCRIPTION' SQ. FT. OCCUPANCCcY,.•��, K os('(•1 - G Address(mailing) -4.,: ysl or - a '_ CONSTRUCTION TYPE V—+` VALUATION $ -5Ca-�— $ Left 0 ' • City License No. 2.,` ©'" J3 ZONE GRADING CU.YDS. ACRES - R LICENSED CONTRACTOR DECLARATION srt�nnn��� ,�yy•�yy • Ping. RCF.# Parkin Re ./Provide E I hereby affirm 7 00) am licensedion under provisionsnCharterroi9 (commencing Remarks: �1, •' �rt5 Planning Notes: Ct�L,� - - M with section 7000) of Division 3 of the Business and Professions code, and. �L / l r / A my license is in full force and effect, . - i .Licens ci ss '� License No O' 2St7 - s Date Signature �1-- -- n • PLUMBING . FEES WORKE Si OMPENSATION DECLARATION l I hereby affirm that I have a certificate of consent to self-insure or a certificate' Bar Sink Showers ELECTRICAL FEES (� of Workers' Compensation Insurance, or a certified copy thereof (Section _ Backflow Presenter Service-Sink. • Automatic Washer - - •Transforme-r :❑ 15-50 KW 3800, Lab. C.) -t�-� - 11.02,•5014—$moiS uc �I -- I - ❑ 50+KW Policy No. Company ST-K1�T TV Backflow Irrigation Sewer Cap ,' Construction Pole Sub. �eertified copy is hereby furnished. L C tilt t tpp is ed with the city ll r..,yaG 1_:,:ti �• .__`! Bathtubs Sewer Connection Cooking Unit Meter El up to 100 amps ci ' Dat 'ION / Applicant /� /tE `��-! , EXEMPTION FROM WORKERS'COM ENS•N DECLARATION Clarifiers Solar Collectors Dishwasher Meter Cover 100 amps (This section need not be completed if the per is for one hundred($100) or - - less). Dishwasher Solar Piping . • Dryers EJGas ❑Electric Sub Panel ' i , 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 Drinking Fountains Motors 00-1 • Workers' Compensation Laws of California. Date Signature Floor DrainsInc. .. 'NOTICE: If;after making this declaration, you should become subject to the Workers' Compensation .provisions of the, Labor Code, you must forthwith Floor Sinks - - comply with such provisions or this permit shall be deemed revoked.' CONSTRUCTION LENDING AGENCY C • - Gas Service • Outlets DeviceI hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which -this permit is issued, (Section_ 3097 Civ. C.) Interceptors • - VVater Heater Lender's Name ' , Lender's Address - Kitchen Sink OWNER BUILDER DECLARATION ' Sign . - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash • following reason (Section 7031.5 Business and Professional Code: Any city or a. . , Standing county which-requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit - Trash Compactor 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). - - - $ 3 .�, • ❑ I, as owner of the property or my employees,with wages as their sole, Reinspection Fee, $15 Issue Fee - - • compensation, will do the work, and the structure is not intended or offered - - Reinspection Fee ; . ! $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code:'The Contractor's - MECHANICAL FEES I 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 SERVE€$$EQUI NTS: ��f�.�P ' employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I 0 Il/{ / / U-] sale. If, however;the building or improvement is sold within one year of com- Canopy Type ii ❑ • Zoning Approved By ( Dat (aC 1 pletion, the owner will have the burden of proving'he/she did not build or im- Duct_Under Ground • Building Approved By (+ Date 1—a_—/1l prove for the purpose of sale). . - , ❑ I, as owner of theiproperty, am exclusively contracting with licensed con- Duct-,Structural Refrigeration System Application Issued By • Date 7(i "L 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 ❑0-100,000 BTU ❑100,000 BTU SUMMAR OF FEES builds-or improves thereon, and-who contracts for such projects with a con- - -- • it , tractor(s) license pursuant to the Contractor's License Law). I am aware that , Exhaust System 0 Multiple 0 System Repair/Alteration • BUILDING PERMIT $ SOn' 0 SMIP $ o 0 proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ 2-n�� PERMIT al am exempt under,Section ,B. & P.C.for this reason Firepl/Fact.Blt. ICBG# - Fire Dampers • PLUMBING $ ISSUANCE $ • Date Owner Heating System& Ducting . Registers . PLAN PLAN CHECK - 25% $ . ENERGY P.C. $ . • I hereby certify that I-have read this application and state that the above Do-1 00,000 BTU 0100,000 BT - - . I - GRADING $ , ' information is correct. I agree to comply with all city and county ordinances �• ELECTRICAL. $ I and state laws relating to building c• struction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $t • sentatives of this city to enter Linn t above-mentioned roperty for (�� 2 �? h inspection 'Tinge • D � � MECHANICAL $ TOTAL FEE $ ' V�J+f IO Signature — Reinspection Fee $15 Issue Fee • $ 3 PLAN CHECK 25% $' i ' Drivers' License or SS ' - ' ' - - • CMF 0865-46,rev.10/84 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor V CONSTRUCTION AND PLANNING - - POOL &SPA it APPROVALS Permit# Date Inspector - APPROVALS Permit# Date Inspector J. Temporary Electrical Service or Pole - - 52. Pool & Equipment Location - ' i 2. Solt Pipe Undrgrnd. • . 53. Steel Reinforcement 3. Electrical.Cond'uitUtility-Undrgrnd: 54. Forms ' 4. Electrical ConduitUndrgrnd. 55. Electrical Bonding , 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UFER'Grnd. . - 57. APPROVAL TO COVER-GUNITE • 7..Footings l j , 58. Electrical Conduit-Undrgrnd. - ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrndi ; 60. Backwash Lines, P-Trap, O 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 I . 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 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 ' 2.3.Gas Pipe-Rough& Test 72. Underground Flush P4, Roof Framing t 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 /' / 'C� 76. Dry Standpipe 28. 'Lathing &.Siding 77. FIXED SYSTEM FINAL 29. Insulation r. 78. FIRE PREV. FINAL 30. Drywall Nailing t` • HEALTH DEPT. REQUIREMENT 3f Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final • . 80. FOOD CERTIFICATE ISSUED 33. Final Electric i°tg- Tea r`' p „ _.C121r •.-`Z92.f` a. 34. Final Heating& Air Conditioning 7/4210- ' ' Ns/ �1c4L en 1i l0 Oni�j't y 35. Final Gas Pipe-Test �� nobit 044 � 5 q -ti /� 36. Hood or Canopy lt/ CS/Y K. l/ 37. Final Factory Fireplace 38. Firial'Plumbing,: - 39. Water Service-Final,- 40. Gas Service-Final 1 _ 41. Solar Domestic-Final i I 42. Backflow Preventer I I i , I - 43. Backflow.Irrigation - 44. ,Landscape Irrigation System, . . • 45. Sound Attenuation' s':' 46. Handicap Regulations � `e { 47. FINAL STRUCTURE & BUILDING ?fsi`�id 642 . 48. Special Requirements Completed ` Z���� i 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ' No- Date