HomeMy WebLinkAbout2404 LA MESA CT - Building Permitsrri
' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTT�BUCTION PERMIT PERMIT (tZ�€ TRACT NO. rete UNIT NO. A P # Zo -
.Project Address 'Z40 LA !", (Outer - 12J yy771I AI LO _ . nu3' 33,2 - 05 �(v "- ► t��l—� -.
A X825 TYPE OF CONSTRUCTION •t.�y NEW. .DD LI ALTERATION U REPAIR. S Main Building: I Accessory Building: _ 2
Applicant's Majlli/pg Address WcSrCL f Vig AAA.it /
' Owner's Name/ vE41/O/-T �AabrA &flee Phon9f'TS `79/� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ` • T Front- l� (� i 'VI O
�/ ./� �p • DESCRIPTION OF WORK/USE OF BLDG.S/NGLE pA et/L7
{ B .Rear, !s/ .0„1- hi - •• N
Address l8t�2-1S I•t�E SrCL/F'P l�/i �✓ I N.e -A ►weLL h,t1- _ 'Al A /. I
Arch/Eng.�11.�ALE FC.46Ep•6 y
License No. C 3d-!G7 TYPE OF PERMIT IIS GRADING . FOUNDATION " STRUCTURAL C Right. /�•� y G
Address /1 S1t,//QI//N6/JLVO*//6 /L/)'('//✓ ❑ TENANT-❑ ELECTRICAL ❑ PLUMBING •❑ MECHANICAL . $ ' Left .4pr1 al b/ _ -
R
Contractor's NamAvgWR3R.,T�iQ2$O,��Loq.S Done (P 7 S- 49/'�7 ❑ 'OTHER • ‘13(-, BAR- Ping. Ref.# p/.}' -87-193 Parking Req./Provided&' •S' /5 • . E
GG ) w 9 n PROJECT DESCRIPTION SQ. FT. 4 sol X-e4- OCCUPANCY F'45SPECIAL '1U1�G111G111S Q
Address(mailing) ��ZV (',4 G4/fj �� / N•B •• CON ST RUCTION TYPE VALUATION Itct73\ Planning Notes:HO� FOR 1L M
City License No. • LOS�07 ZONE GRADING CU.YDS. • ACRES g•
LICENSED CONTRACTOR DECLARATION •
..II'']] - ' l(� / 1 c,� ( c ,
I hereby affirm that I am licensed under provisions of Charter,9 (commencing Remarks: 'r�Ani f ONE i •-5 cr th #Fom 6iGlltfO /VabL'/ '
with section 7000) of Division 3 of the Business and Professions Code,and I
my license is in full f co and effect, p p - c I 3 bs" !'] Q ELECTRICAL .FEES
License Cla s - ( icense No.�� Z 1G� J -_`l C.:J� 'utomatic Washer Transformer ❑ 1550 KW
Date - - Signature - PLUMBING FEES
WORKERS'COMPENSATION DECLARATION / Con uction Pole Sub. 050+K •
• hereby'affirm that I have a certificate of consent to self-Insure or a certificate rBar Sink •
Showersms�
Workers' Compensation Insurance, or a certified copy thereof (Section 4
Cooking nit ' . / Meter Sup to 100am•
W '
00, Lab. C.1.- - - B.:.flow Preventer Service Sink -- - . . . . . - — --. .. __.... .. -.. ._.. .....
Policy NObJpti5S300% CompSny Fe2Emo' -r /NS= • / Backflo' Irrigation . SeweCap ;!� '+ '' ( DishwasherheMeter Dover: 100 Wimps • ,
•
fly Certified copy is hereby furnished. }' /• / Dryers IaGas lectric Sub Panel
Da
Cert iffletl l x ( ed with the city.Buil gyyf�r>� Bathtubs / $ewer,Connection�`^ -%. -mss-+
Date LP- 1 I CVs T% Applicant. • • ��,///lllrrr - ; - / Fan Mot• ❑0-1 HP 1'/:--8 !
EXEMPTION FROM WORKERS'COMPENS TION DECLARATION Clarifiers Solar-COIIeCtOrs`(This section need not be completed if the permit is for one hundred ($100) or - - - / . - .- "' nC:Solar D9-15 HP-016-15+' -'
• less). • / Dishwasher Solar'Pipin9• `. FIA.U.I certify that in the performance of,tlie work for which this permit is issued, I Fixtures
•
shallfnot employ any person in any,manner so as to become subject to•the Drinking Fountains Solar Tan ;' :.' Microwave !l�,
Workers'.Compensation Laws of California. ,.;' Device Boxes '
Date Signature 'r - • ' Floor Drains . Swi• ing Pool w/Spa I,% '• - Light �/': .
OTICE: If,after making this declaration, you should become subject to'the — - -
Workers' Compensationprovisions of the Labor Code, Floor Sinks inal Outlets / g
you must forthwith - - - ��" Range
_ _
comply--with such provisions or this permit shall be deemed'revoked. '-
CONSTRUCTION'LENDING AGENCY - I Water Oset ' ' - Switches " • .
Gas Service 5 Outlets .. .�I Sign
I hereby affirm that there is a construction lending agency for the performance ' '
Lof the .work for. which this permit is Issued (Section 3097 Civ. C.) _/ Garbage:Dis••sal ' Standing Sections
Lender's Name - Interceptors; / Water Hear •
Lender's•Address - / Kitchen Sink _ Water Service '` Genera'•r X65 KW(]5-15 KW Trash Compactor
OWNER BUILDER DECLARATION Y
I hereby affirm that I am exempt from the Contractor's License Law for the 9 Lavatories /. '-Auto-Wash
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 . . -- ^- '
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 Dfai - - ♦,
the Contractor's License Law(Chapter 9(commencing with Section 7000)-of ' '— ,
vision: 3 of the Business and Professions Code) or that he/she is exempt - ReibspeCtiOfL F¢e $15 Issue Fee • $ 3
aarefrom and the basis for the alleged exemption. Any violation of Section , _ .
:'A'.5 by any applicant for a permit subjects the applicant to a civil + -
'natty of not more than five hundred dollars($500).- I 'DEVELOPMENT SERVICES REQUIREME T
I. asl owner of the property or my employees with wages as their sole . - Reinspection•Fee , I $15 Issue Fee - • $ 3' '
I Zoning-Approved By j - Dat al X88
compensation, will do the work, and the structure is not intended Contractor's
red _ _ - , - I
for sale: (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES ;Building Approved By. _ ('� Date •/ •
License Law does not apply to an owner of a property who builds or improves - IiCatiOb'ISSUBd By �� t �X FF" - lT� --(Ye
' thereon, and who does such work.himself/herself or through his or her own - . App nate
employees, provided that such.improvements are not intended or offered for Boiler - • Hood or, Type I D.
sale. If, however, the building or improvement is sold within one year of toms - Canopy Type II D - - • - . : ","';-_„ , ,f : SUMMARJ(OF FEES - - '
pletion, the owner will have the burden of proving he/she did not build or im- duct- Under Ground ' f SL
prove for the purpose of sale). - - L /BUILDING;PERMIT $ 'SMIP , ' $ 1 i
•
❑ I, as-owner of the property, am exclusively contracting with licensed con-' Duct tructural Refrigeration em I PLAN CHECK $ PERMIT' ,
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-Venti . 'ng . D0-104,%10 BTU.D100,000 BTU - PLUMBING $ ISSUANCE $
builds or improves thereon.and who contracts for such oroiects with a con- - - - 'ENERGY P.C. $ 1
• tractor(s) license pursuant to tne,Contractor's License Law). I am aware that ExhaustpSystemMultiple ■ p�stem R air/Alteration • - I PLAN CHECK 25% $ _ '
proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ 1 GRADING $
0 ham exempt under Section B.& P.C.for this reason 2 Fire I/Fact.Blt. ICBG Fire Danvers PLAN CHECK 50% $ .
4MICROFILM $ 9112-
-1
�
Date • - Owner! • . Hating System& Ducti•• ' Registers ' MECHANICAL $ 'TOTAL FEE $ • q1'1Z
-I hereby certify -that I have.read-this application-and state that the above-- - 1 140-100,000 BTU ■ 00,000 BTU • - - - - "- 4
PLAN C •
HECK 25%
information is correct. I ay-- to comply with all city and county ordinances ' ., $ - •
and-state laws rola g to b ilding construction, and hereby authorize repre- -
sentatives of'this ty t• e • upon the above-mentioned property fpr
Inspection PurPos // 77 ((J�lylf, + ,% • ;
' Signature • !!! rY Date6.//- -/ 'I,
o
i
penspectin Fee ♦
Drivers' License or.ss -, 3I $15 Issue Fee $ 3 •T"
_ 01 00007566-000. 07.5,63. To-r.. . . 91117.72
/ 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor r -....
__
•
CONSTRUCTION AND PLANNING �' POC SPA
APPROVALS Permit# Date Inspector APPROVALS • Permit# Date Inspector
ti
1.. Temporary Electrical Service or Pole 52. Pool & Equipment Location .
2. Soil‘Pipe Undrgrnd. 07 qj 53. Steel Reinforcement - -
'': EleciriEal'Cond6!t-Utility-Undr•ggnd. ? •27 : 54. Forms •-•;•••'.Z'
r4. Electrical Conduit'-Undrgrnd. --' RI 55. Electrical Bonding •
.•-L q n i.
5. 'SteeCReinforceriien't [) 56. Rough Plumbing & Pressure Test • / 1
6'• Electrical UFfR-Gknd. �� 57: APPROVAL TO COVER-GUNITE 1L7
•
7.r. For�tings: cit ,6 n` ' 7 58. Electrical Conduit-Undrgrnd.
/ t5$ ...-
•
8 F`undation>* c orf t 59. ,Gas Pipe, 0 Undrgrnd.,Test
9i Water Pipe-Und gmd. C .; , . 60. Backwash Lines;P-Trap,.0 Undrgrnd. ice'
1, IA)
•
10iStiuctural Floo"orM1iSystem ,:. I \) 61. APPROVAL TO DECK
11? Property Sewer Line & House Connection 9 ' ' 62. Backwash & Rece for-Final
1 •`S J e Ii r p - n.
12. Se i4? Capl ' y r 163. Heater & Vent-Final
13. .Rbd(Drains `P 5 f» Al 64. Plumbing System - Final _ ,�/
n-
14. 'Rouclh Plumbin lT 65. Electrical-Final JJ
9
15. Rough Electrical-Conduit 66. Solar System-Final •
Ll -- • . / . _
r16 Rough Electric Wiring t\ 67. Fencing & Access Approval },
. 17: Rough Wiring Sign ' ' \ 68. APPROVED FOR PLASTERING \
•
'1181 Rough Electrical-T Bar CeSling ' r 69. POOL/SPA SYSTEMS FINAL \
.. . e! Rough Heating & Air Conditioning \ rt„ FIRE DEPT. REQUIREMENT \ /
' 120. Rough Factory Fireplace p \ APPROVALS/ Permit# \`\
21: Ducts, m Structure it \ 70. Underground Hydro \n,
22..,Ducts, Ventilating H. \ 71. Prod•
uct Piping 0 Gas 0 Oil 0.\
23. Gas Piple:Rough & Tet U -- \ .72.,,Undergro .nd Flush ,` �\ '
- 24.,Roof Framing t �,'� rP cV - \. (73. Undergrnd.Storage Tank 0 Gas 0 Oil / , \
254 EjooftSlieathinglr7 -- 1 /r' � /////'///rD r "74. Overhead Hydro \
.26. T-Bar'Ceiling (Structural) & Monotoat III_ 5 78'364 i Dry Chemical • \
�27.`Frame and Flashi g ( 8 76. Dr`y Standpipe /
28. Lathing`%&ISiding `l /7-111- VW, 77. FIXED SYSTEM FINAL :
29. Insulation f`vt i*Wet . ' 78. FIRE P9EV. FtINAL
30. DrywallY;Nailing •'.. /Sy/PB 4, HEALTiH DEPT. REQUIREMENT •
31. Plaster Brown Coat 0 SSSS���� _ 79. -FINAL INSPECTION /
32. Electrical Power,Nleter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric I '' '' Notes: .
34. Final Heating & Air Condrtioning„• - l - ._. _ rii n ,t$OJ.D FOR SPECIAL REQUIRE r;,
35. Final Gas Pipe-Test = S•o • G. \ \1 a$r
,,6. Hood or CantoPY '' C.
ne,fr Otocbikt.1T c lL 2.
37. Final'F,actory;Fireplace �• l
38 Final Plumbing • r , /
39. Water Service-Fina l} \\ /. -•
40. Gas Service-Final, 1. \ /
.41. Solar Domestic-Final \ / . r1 -
42. Backf low Preventers . �' . ,-- lZ 'A:1 :;
43. Backflow Irrigation' '\ •-
. �� I
44. Landscapellrrigation System / \ ,, I
45. Sound Attenuation `'
46. Handicap Regulations •
-, / Si:
47. FINAL STRUCTURE & BUILDING - &Mg Z \
48. Sneeial Requirements Completed / S////M '.- D,/Wl:Ik ,\
.49. Electric Release to Edison / / (*^ •\ I
-50. Gas Release to Southern California Gas Co• \• - -•
.51. CERTIFICATE OF OCCUPANCY . ' \ ,- - 'I;r '"1! , '
No: - Date ,/,` i ;'1� ,.
. 1
•
4 '.in .7 n` . •w•."'4:::....:47 ri',n• - ldi lam_ •fl M• . . . . M. .4
i INSULATION CERTIFICATION 3
r/ ..This is to certify that insulation has beeninstalled in conformance with the � '
=.� current energy regulation, California AdministrativensCode, Title 25, State of ' '
California, in the building located at:
. . . STIE ADDRESS 2404 La Mesa Ct. , Costa Mesa #.41')((" CEILINGS 6 1/419 W
t( • ' Batts: Type Fiberglass i. u�facturer Owens/Corning Thiclmess9 1/2 R-Value 30
1: Blown: Type Manufacturer Thickness R-Value ii'
n , EXTERIOR WALLS ,
�. i
l!,e; Type Fiberglass Manufacturer Owens/Corning Thickness 3 1/2 R-Value 11 �,�X
l�,'� FLOORS Type Manufacturer 'Thickness R-Value % <
31.1
General Contractor License I ,
`� 1 ,
Y :, By Title Date. '
%• ScFaaid Insulation Contractors, Inc. License t 221517 C-2 ? � :
irs$t :
/ , r[By /��.-.-- ,, Title Vice President Date April 13 , 1989 Via,
., tis'i�'1 /` �'�",..�•' L)�'.'^i_ \ ,�, 3'. i
�. t/--..n�/- ,r+ ..t+ y >. • r �ti.w _ to �S V : r 1 u'$-
INSULATION CERPIFICATICN io
�t
G* This is to certify that insulation has been installed in conformance with the i �4
S,- : current energy regulation, California Administrative Code, Title 25, State of •li.
r , Cllifornia, .in the building located at:
Fe SITE ADDRESS 2404 La Mesa Ct . , �• r
QCosta Mesa
tti CEILINGS 6 1/4 19 3% ;'{
�p�a!' Batts: Type Fiberglass Manufacturer Owens/Corning Thickness9 1/2 R-Value 30 ;:
y D .
r;. :Blown: Type Manufacturer Thickness R-Value io's',.
EXTERIOR WALLS ?.�'
Nom.: •
/Fa Type Fiberglass Manufacturer Owens/Corning Thickness 3 1/2R-Value 11 44.*
, ' FLOORS Type Manufacturer Thickness R-Value '
General Contractor License I 'r' '
.) By Title Date %)•
7
=� ";Schmid Insulation Contractors, Inc. License I 221517 C-2 )3li.
t.
'•� BY G) .24i. Rq,uw Title Vire President Date April 13 , 1989 3r
-\W.... . , Mr w•. Wi w .N5: -w w, w. •w %VI' :w' %w
ri
I,
ROSIN S. HAMERS a3a n e Qoe
& ASSOCIATES, INC.L car.mesa.ca.020117
CIV ENGINEERS N
PLANERS LI
BRVEYORS p+41048-11ss . .
I
I
April 28, 1989
Mr. Gary Conlon
City of Costa Mesa
f Engineering Division
77 Fair Drive •
Costa Mesa, CA 92628
RE: TRACT NO. 13456
µ 276-280 SANTA ISABEL
a Dear Gary:
•'', Enclosed please find nine copies and a duplicate mylar of the
recorded tract map. The final monuments as called for on the map
were set on April 26, 1989.
The finished grading has been completed substantially in
accordance , with the approved Grading Plan as determined on
April 28, 1989.
If further information is required, please contact me at (714)
548-1192. , ,
S rely,
Rob n B. Hamers `
RBH/jp
•
cc. John Peterka
• - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PE MIITTN TRACT NO. LOT NO. UNIT NO.
Project Address zgaY L# • in-f4-- Cote.e ? 4 I 37 a l� -- �� •
Applicant's Mailing Address Pd acme 76.7 i `�./„ TYPE OF CONSTRUCTION U NEW ❑ ADD ALTERATION U REPAIR r
N p / Cif Phy! CONVERSION ❑ DEMOLISH CI OTHER A P # I Zone
Owner's Name iL✓ OKT C4-to/ C As eS 1� - ..
�G%, erOr• �� ' DESCRIPTION OF WORK/USE OF BLDG. g_ •
Address ,!Y- • S Main Building: AccessoryBuilding:
TYPE OF PERMIT ❑ E Z
Arch/Eng. License No. GRADING ❑ FOUNDATION STRUCTURAL T Front 0
Address / ❑ TENANT ❑ ELECTRICAL 1M PLUMBING ❑ MECHANICAL B Rear • N
CI Contractor's Name P'r�G m Spst75 o/a Phona•� OTHER - _ C Right N
Y PROJECT DESCRIPTION SQ. FT. •OCCUPANCY G
: Address(mailing) " 'LhQ ,,11 [''_ CONSTRUCTION TYPE VALUATION,$ _ S Left "
City License No. 4 7 Y\V ZONE ,GRADING CU.YDS. ACR S RE
LICENSED CONTRACTOR DECLARATION Ping. R¢f.# Parking Req./Provided
CI
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: fJ / v• tf-�r p 3 7 Planning Notes: • . ' M
with section 7000) of Division 3 of the Business and Professions Code, and /7(�GL Q� Pte+ U T ,
my license is in full force and effect. -
License CI.-s — — // Lic,t- No.Y9j D.•i, • $.
Date cf. Signature ./t . ._ PLUMBING FEES .
WORKERS'COMPENSATION DELL• RATION • Bar Sink / Showers 2 N ELECTRICAL FEES -
I hereby affirm that have a certificate of consent to self-insure or a certificate
af Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink • "
3800, Lab. C,) /,rJ •/ _ Automatic Washer ' Transformer 0 15-50 KW
Policy No. e73LY77+g7 Company 3i4S-e 4p_Pl'. Backflow Irrigation I� Sewer Cap _ ❑'50+ KW .-
Construction Pole'Sub.
8 Certified copy is hereby furnished. -
Certif ie copy is filed with the city Bui • ivlsion 3 Bathtubs • Sewer Connection It; ,w Cooking Unit Meter Dup to 100 amps ,
Date C1 X 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). J Dishwasher Solar Piping - 2, N 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❑0-1 HP 01%-8 '
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP ❑16-15+
, 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
Microwave /
comply with such provisions or this permit shall be deemed :revoked. - 'L /sem
CONSTRUCTION LENDING AGENCY r'- I/ Gas Service Y Outlets 3 Water Closet 8,sc Device Boxes ' Pole Light VIZ
eI hereby affirm that there is a construction lending agency for the performance
" 1 of the work .for which this permit is issued (Section 309`%Civ. C.) �,' Interceptors • / Water Heater 2 r. Outlett. Range ;
w Lender's Name _ - - s
(1] Lender's Address • - - _ -' - / Kitchen Sink ,, Water Service • -4 h. Si
Switches - -
��//__ -OWNER BUILDER DECLARATION i� Sign
I I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto'Wash 12._ lyGarbageDisposal 7 Standing Sections i.,,
l 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
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 3 Roof Drains - •
..
the Contractor's License Law (Chapter 9 (commencing with Section 7000)of
P Division 3 of the Business and Professions Code) or that he/she is exempt
-.3. 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). II $.3
I, as owner of the property or my employees with wages as their sole Reinspection ion Fee $15 Issue Fee "
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 -
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 0
' -sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
' pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By _ Date
prove for the purpose of sale). - _Z 7�v
IDI, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date yys.s
e.
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 0100,000 BTU - SUMMARY OF FEES -
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 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers - PLUMBING $ ISSUANCE $
Date - owner Heating System& Ducting Registers PLAN CHECK 25% $ 9 ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $
information is correct. I agree to comply with all city and county ordinances ,
and state laws relatin• o building instruction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ -' -
sentatives of this C//'o enter on the above-mentioned property for
inspection purpose/' O ? ( ✓ MECHANICAL $ TOTAL FEE $ .] /•-S
Signature -t L Date44
- Drivers' Licen or 5$la -
— — ' Reinspection Fee $15 , Issue Fee $ 3 • PLAN CHECK 25% $
•
cla puuUV 130—UUUULI 1J 9 L' I Z:11:13CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
iV
•CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# .. ,_ Date Inspector APPROVALS Permit# Date Inspector
1tsTemporary Electrical-Service or Pole rDy'��y� 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. J 7,P4/F'�i�„t"" 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 UFERGrnd. 57. APPROVAL TO COVER-GUNITE
•7. Footirids' „ ., 58. Electrical Conduit-Undrgrnd.
8. Foundation. 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe`-Undrgrnd. ;74p '1p ,, �r�/�57 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 - 101,0 L/p 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
.1
1Rough Electrical-T Bar Ceiling 1 V•__r
8. L.;, 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 • - .'i
24.. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil '.
25. Roof Sheathing 74. Overhead Hydro ll-
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,j
27. Frame and Flashing --- ---f.,l 76. Dry Standpipe .4
28. Lathing & SidingI,) '
b.
77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL :•,
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat e'f 79. FINAL INSPECTION L, 7
7 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED (.
33. Final Electric Notes: Y-
34. Final Heating & Air Conditioning ,ir
35. Final Gas Pipe-Test JJ�/%0�11"A -::- A
36. Hood or Canopy
37. Final Factory Fireplace / :a .i
r" - r
38. Final PlumbingD/91 ry{
C. r - 7
39(Water Service-Final - ' . s• =Y -
i
,40. Gas Service-Final I _ 17 ` - ! '
1'41. Solar Domestic-Final . - )# .1i r
I . 4 . , v
42. Backflow Preventer ✓ U i,
(/ (i
43. Backflow Irrigation - 1' i .
1f44. ,Landscape Irrigation System - '� ( : r`I 71J' .i: I
45. Sound Attenuation ti , A t• 'Y �i I- •
46! Handicap Regulations • • ,,� I. r"c i'
47. FINAL STRUCTURE & BUILDING ;
48: Special Requirements Completed .r f, / ' '
. i"_
49. Electric Release to Edison - '• .
- I' , P.
,,
50. Gas Release to Southern California Gas Co 'v
51. CERTIFICATE OF OCCUPANCY. •- . -
No. Date - '
'.,
..-
Applicant
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OP COSTA MESACO STR/UCTION PERMIT� PERk!}fT_NO,`� / TRACT NO. LOT NO. UNIT NO.
2•
y07 4 '7n,jien ( ��IV/Il1l �J A.P.# • Zone
Project Address ` qq�� /' ''/ ff � S Main Building: Accessory Building:
Applicant's Mailing-Address /5"-3�AtevtelV7� �e4 100 9 ze, 3 TYPE OF CONSTRUCTION LJ NEW LI ADD ❑ ALTERATION U REPAIR E , , Z
�y_ n ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' T Front - . - 0
Owner's Name 4€1.7d)f•p vr7 p�tin• Phone Ayr y9/3 DESCRIPTION OF WORK/USE OF BLDG. B Rear N
Address / A - I
•
•Arch/Eng. License No. TYPE OF PERMIT ID GRADING' ❑ FOUNDATION ❑ STRUCTURAL [ C Right N
Address ID TENANT ❑ ELECTRICAL ID PLUMBING ID MECHANICAL S • Left - - G
R
* � -7 ❑ OTHER •
Contractor's Name .c Kn7,tfj� Syn"y`s Phone�V /6�r Ping. Ref.# Parking Req./Provided E
Address(mailing) (C0-7;41) PROJECT DESCRIPTION SQ. FT. OCCUPANCY M
Planning Notes:
'CONSTRUCTION TYPE VALUATION$
City License No. - 3z 36 Z/ • T
• ZONE GRADING CU.YDS. ACRES - S.
LICENSED CONTRACTOR DECLARATION - -
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 2 �j '
with section 7000) of Division 3 of the Business and Professions Code,.and 97-3Y 23 a ,
my license is in full force an effeZcto_ • l9 `� • ELECTRICAL FEES
License Class i License No.
it Date tnaSignature f. - .a_ Automatic Washer Transformer". PLUMBING I FEES0 15-50 KW
WORKERS'COMPENSATION DECLARATION - Construction Pole Sub. 0 50+KW
hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers
r
af Workers' Com WionIOssurraance, or a certified copy thereof (SectionCooking Unit Meter ❑up to 100 amps
3800, Lab. C.) i ify 2. 0.y ^ ..{�- Backflow Preventer Service SinkPolicy No. _CompanyBackflow Irriation Sewer CapDishwasher Meter [Dover 100 amps
v L�y1.Certified copy is hdeby furnished. T —
1 Dryers ❑Gas ❑Electric Sub Panel
LD Certified copy is iled with the city BW i 9 Div'3ic s irr, Bathtubs Sewer Connection
Date II—� fQ Applicant ' svvL-� .- , 'J
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers 1.-- Solar Collectors • / Fan Motors 00-1 HP Di'A-8
(This section need not be completed if the permit is for one hundred ($100) or F.A.U. Inc.Solar 09-15 HP 016-15+ -
less). Dishwasher Solar Piping
I certify that in the performance of the work for which this permit is issued, I e .. Fixtures
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank !% Microwave
Workers' Compensation Laws of California.
Date Signature - ....
t Device Boxes
g Floor Drains Swimming Pool w/Spa • J J Pole Light
' NOTICE: If,afteng this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal • Outlets Range
comply with such provisions or this permit shall be deemed revoked. '
CONSTRUCTION LENDING AGENCY. - Gas Service Outlets Water Closet Switches Sign
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater - Garbage Disposal Standing Sections
Lender's Name - • :
Lender's Address Kitchen Sink • - ' Water Service Generator 00-5 KW 05-15 KW Trash Compactor
OWNER BUILDER DECLARATION -7'
-
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
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
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 Reinspection Fee $15 Issue Fee $ 3
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 DEVELOPMENT SERVICES REQUIREMENTS:
❑ 1, as owner of the property or my employees with wages as their sole Reinspection Fee ` $15 Issue Fee $ 3 Zoning Approved By Date
fom sale (Section
will 0 the work, the of scion is not intended orofferrtl • -
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
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 Application Issued By Date
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 02
1 sale. If, however, the building or improvement is sold within one year of com- - - - Canopy Type II 0 SUMMARY OF FEES
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground •
iprove for the purpose of sale). BUILDING PERMIT $ SMIP $
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
• 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 ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con- PLUMBING $
tractor(s) license pursuant to me Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me; - - - - - ELECTRICAL $ GRADING $
❑ i am exempt under Section B.& P.C.for this reason' Firepl/Fact.Blt. ICBO# Fire Dampers
PLAN CHECK 50% $ MICROFILM $
Date to en-1r r Owner He ting System& Ducting Registers 9 ! ^^� r O ^�//
� JJ MECHANICAL $ Oc� TOTAL FEE $' eza e,06
I hereby certify that I have read this application and state that the above I 200.1 00,000 BTU ❑100,000 BTL— ...-
information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $
and state laws relating to building construction, and hereby authorize repre- '
inspection
fives of this Cit]( [y en r u he rabove-mentioned /p,.rrooperty for
'Signature purposes {/�— Date /�/ 4 te -
Drivers' License or SS Reinspection Fee $15 Issue Fee V-7 $4 01 00017493-00017493 TOT 24.00
> PJ DATE: 10/19788 TrnE: 15:22
0865-46,rev.5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
• CONSTRUCTION AND PLANNING POOL& SPA •
APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector
T. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. v 53. Steel Reinforcement
3. Electrical Conduit UIility-Undrgrnd. % ; '1 _i 54. Forms' j,.
4.,Electilcal Conduit-Und grnd. '1 55. Electrical Bonding"-
S...Steel(Reinforcenierit •-' - 56. Rough Plumbing & Pressure Test ' •
4 /.t
•
6. ElectricalUFER'.Grnd?! C zt 57. APPROVAL TO COVER-GUNITE ';1
7. FoOfings •t. •') .i - 58. Electrical Conduit-Undrgrnd. ' •'
I .
8.•Foundation / 59. Gas Pipe, 0 Undrgrnd.,Test • ;i•;
9;'Watei Pipe-Undrgrnd. • i ' 60. Backwash Lines, P-Trap, 0 Undrgrnd. 4,'
a
10;Structural Floor'System - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection ^ -le 62. Backwash & Receptor-Final
12.'Sewef Cap 63. Heater & Vent-Final
13:Roof-Drains i 64. Plumbing System - Final
14. R6ugh Plumbing- �r 65. Electrical-Final ��•
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval J
41.7• Rough Wiring Sign 68. APPROVED FOR PLASTERING
,18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
119. Rough Heating & Air Conditioning 16-2o' re 60 FIRE DEPT. REQUIREMENT
•20. Rough Factory Fireplace APPROVALS Permit#
i-21. Ducts, in Structure , 70. Underground Hydro-
22. Ducts, Ventilating 'U 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 / V
31. Plaster Brown Coat • 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric �,r,�� Notes: - -
34. Final Heating & Air Conditioning 1,/2/e�?'��r .
35. Final Gas Pipe-Test - 7 ` / i<`
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final -, -
-40: Gas Service-Final
41. Solar Domestic-Filial '
42. Backflow Preventer
43. Backflow Irrigation C-1 r� •
44. Landscape Irrigation System • ,
, 45. Sound Attenuation _ .
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Snecial Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -�
�• !1.
51. CERTIFICATE OF OCCUPANCY 'l' 0
No. Date ' ,�, '.7
>` •_ - L.�61 ` ,..._ ,�._,t Applicant to fill in all spaces except those within heavy border lines and sign all appropriate decla ratio nz. ,
CITY OF COSTA MESA CONSTRUCTION PERMIT t, PERpQ NOS&ad ,TRACT NO. LOT NO. UNIT NO: , ,
PLoject Address MnnGE.-7- � ,' ��/� r
Applicant's Mailing Address I L 1F�,t-Irl PF (O N.FS /ICYPE OF CONSTRUCTION '}/'/ANEW L� ADD ❑ ALTERATION Li REPAIR '
1 ) ❑ CONVERSION ❑ DEMOLISH ❑ OTHER i _ A.p # •
Zone
Owner's Name./4 -) 'LT 1-IbJZN,�'1�f�-C4T,one (,� [r - - - - - - - - -
/ q� /� D_ RIPTION�W`OR—K/U_SE BLDG. � 1. i- �� •
Addressle S IL)GSTu-'IPF /`, At rz• L7J1�G,C) • •-n S-' �� S Main Building: 01 Q�O21'L4ccess"o_ry8_t things T0T /E .0( '
Arct/Eng i
CONSTRUCTION AND PLANNING - • POOL &SPA
r Date Inspector .. Date Inspector
APPROVALS Permit# APPROVALS Permit#
1.-Temporary Electrical'Service or Pole 52. Pool & Equipment Location
2.:Soil Pipe-Undrgrnd. J - 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.'F.oundation 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 Drains64. 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 Sigh - • 68. APPROVED FOR PLASTERING
.18. Rough Elegtrical-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 -i-
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil -
25. Roof Sheathing - 74. Overhead Hydro .1 .
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ✓ i
27. Frame and Flashing • - 76. Dry Standpipe t4
28. Lathing &,Siding 77. FIXED SYSTEM FINAL /
29. Insulation'•' 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT �;
31. Plaster Brown Coat t 79. FINAL INSPECTION i .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED %r.
33., Final Electric Notes: - - _
34. Final Heating & Air Conditioning
r
35. Final Gas Pj'je-Test
36.•Hood or Canopy )'"
3T Final Factory Fireplace %($//f9 Mr I , : �''!NF
38i Final Plumbing - k. ,'r. ....,/ - .. t.i?
39. Water Service-Final - ' " r _ : '
i
'40. Gas Service-Final ' i
41. Solar Domestic-Final - : •-
I 42.:Backflow Preventer -f
43.' Backflow Irrigation ' . j• - .. - '', ii; ' I--
• 44. Landscape Irrigation System ' . .• ' i/
.45: Sound Attenuation • r. • '`• U
46. .Handicap Regulations V .
{ y � i �
47-[FINAL STRUCTURE & BUILDING ", - .' 4 •
48..Special Requirements Completed - . " '•
49. Electric Release to Edison 1. ,',.,
50. Gas Release to Southern California Gas Co - - E-
51. CERTIFICATE OF OCCUPANCY , ,
No. Date r`
I
TApplicantto fill in all spaces except those within heavy border lines and sign all appropriate declarations.
7
A MESA CO N$TR UCTION Pg.:TT PERMI O35707
/_ / TRACT NO., LOT NO. UNIT NO.
CITYY� • •yhI �// lam}. /Ve3 SflJ �(Q I _ A.P.#' . zone
P.rofeOt Address d K D ��E5 `• _ E Main Building: ,. Accessory Building: z
%• ' ' TYPE OF CONSTRUCTION ' - NEW LJ ADO U ALTERATION .❑1 REPAIR
Applicants Mailing Address -,❑ CONVERSION. ❑ DEMOLISH El OTHER T Front O
Owner's Name New Vo1� ul L.nPhone .DESCRIPTION OF WORK/USE OF BLDG.; - A Rear - N
Address • ' • - I�-1 - • " -
LJ STRUCTURAL - • C Right - - - N
Arch/Eng. License No. _ TYPE OF PERMIT GRADING ❑ FOV FOUNDATION • K' .- G
Address. - QQ '// ❑ TENANT ELCTRICAL ❑ PLUMBING ❑ MECHANICA•L • $ Left - . . R
/J EL�ix/ C- Phone ftp . ❑ 'OTHER • - i-6 A-rn-S� Pin Ref:# " ' • - ParkingRe /Provided ' - E
Contractor's Name SZ3�337 t-- 9 q.
PROJECT DESCRIPTION `SO. FT. _ 7 OCCUPANCY . - Q
Address)mailing) T3 f ��LE*o1/l.Cv"v�� 7 - .Planning Notes: - - M
• CON STRUCTI ON TYPE .VALUATION $ '
i( City Licen3e No. '�✓� (i 2—I ZONE - GRADING CU.YDS. - ACRES T
. LICENSED CONTRACTOR DECLARATION - - S.
I-hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - --
with section 7000) of Division 3 of the Business and Professions Code, and ��/•� • .. s
•my license is in full orce a • 'fleet. 00 _ Zj J O - ' • ELECTRICAL • FEES
•
License la 5_ L',-n410• -
0� Date 4S?r- !O . i%'f re /�_� ,.J1- i PLUMBING . FEES Automatic Washer Transformer 0 15-50 KW
60 WORKERS'COMPENSATION DECLARATION - - Construction POIe Sub. ,❑ 50+ KW
hereby affirm that I have a certificate of consent to self-insure or a certificate • Bar Sink Showers
f Workers' Compensation Insurance, or a cern tie• copy thereof (Section - Cooking Unit i Meter ❑up to 100 amps ,
,� - - Backflow P.reventer _ _ Service Sink - .. - -. - ! - � /�[J
00, Lab. ?e}8:01/19,7/
,.l Palm o.• .-Company •'f ''-" Backflow Irrigation Sewer Cap . r Dishwasher Meter Dover 100 amps
l�1 y,�ertified copy is hereby furnished. , s
` LJ certl'I�d TVs filed with the city Build js Divi 1 / i , Bathtubs Sewer Connection Dryers OGas ❑Electric Sub Panel
Date (!(� // Applicant ./- . // /. / Fah - - Motors ❑0.1 HP ❑1N,'-8 1
EXEMPTION FROM WORKERS'COMP SATION DECLARATION ' Clarifiers Solar Collectors -
-(This section need not be completed-if the permit is for one1hundred ($100) or ,- Inc Solar 09-15 HP 016-.15-eless). - Dishwasher - - • Solar Piping . I -.In` F.A.U.
1 certify:that,in the performance of the work for which this permit is issued, I ' - Fixtures
snail not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - - Microwave -
Workers' Compensation Laws of California. -
Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light
NOTICE: If,after making this declaration,you should become subject to'the --
..%'
Workers' Compensation provisions of the Labor Code, you must forthwith • ' Outlets •
Floor,$inks._ _ .- Urinal _., _ - 9 .. _. ..
comply 'with such provisions or this permit, shall be deemed revoked.
CONSTRUCTION LENDING AGENCY '-, ' - . . Water Closet - Switches - Sign • - - _` 70
Gas Service Outlets 9
I hereby affirm that there is a construction lending agency for the performance - ,
Of the (work for which this permit is issued (Section 3097 Civ. C.) •- Garbage Disposal Standing Sections
Lender's Na nIC - '" Interceptors Water Heater. •
Lender's Address - Kitchen Sink' - Water Service ' • - Generator 00-5 KW 05-15,KW Trash Compactor' •
OWNER BUILDER DECLARATION ' ' - - - -
, . I 4
I hereby affirm that I am-exempt from the Contractor's License Law for the Lavatories . - Auto-Wash - ' ' 7-7--e _
.
following reason (Section'7031.5 Business and Professional Code: Any city or - - �r p C
county which requires a permit to construct,alter,improve,demolish or repair P—Trap - : _ Laundry y _ - • - �aL Cs • • ��
any-structure, prior to Its.issuance, also requires the applicant for such permit - " Tra'S'
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 -
livision 3 of the Business and Professions Code) or that he/she is exempt' _ Reinspection Fee $15 Issue Fee //5-r2.-Q-
'erefrom..and the basis for the alleged exemption. Any violation of Section . - .
331.5 'by any applicant for a permit subjects the applicant to a civil . - -
.�++.e.,nalty of not more than five hundred dollars($500).. - - - DEVELOPMENT SERVICES REQUIREMENTS: • '
LI 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 structureis not intended or.offered - Zoning Approved By - Date
•
for sale (Section'7044, Business and Professional Cotle: The Contractor's: •_ , MECHANICAL FEES Building Approved By'
License Law'does not apply-to an owner of-a property who builds or improves _ _ - - Date•
�/� �s
thereon, and who does such work.himself/herself or through his or her own Application Issued By ' Date !A/r `�
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 ❑ SUMMARY OF FEES •
pletion,:the owner will:have the burden of proving he/she did not build or im- Duct- Under Ground '
prove for the purpose of sale). , - - - BUILDING PERMIT $ - SMTP $
❑ 1,-as owner of the property, am exclusively contracting with licensed con-. Duct-Structural Refrigeration System PLAN CHECK 1
tractors to construct the project (Section 7044,Business and Professions Code: $ PERMIT
The Contractor's License Law does not apply to an owner of property who: Duct-Ventilating I -. ' 06-100 000 BT U;❑100,000 BTU PLUMBING $ ISSUANCE ' $•
' builds or improves thereon:-and who contracts'for such oroiects-with a-con- - -`- - - - - - - -- -' - - ENERGY P.C. $
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $
proof of their worker's Compensation insurance should be provided to me. ELECTRICAL--------4., •
GRADING : $
❑ I am exempt under Section B.& P.C.for this reason . . Firepl/Fact:Blt. ICBO# Fire Damper's •
f
' - •
- - PLAN CHECK • 50% $ r MICROFILM ' $
Date - i ` owner' • - •
• : - Heating System& Ducting _ Registers
herebycertify-that- ,„ -. MECHANICAL $ TOTAL FEE l $
I y I have read this application and state-that the-above ' ❑0-100,000 BTU ❑100,000 BTC,- ,
Information is correct I agree to compl��1 ith all city and county ordinances PLAN CHECK 25% $ _ S
antl state laws rel. to builds , tion, an•: ereby authorize repre- -
sentatives of:•• - qty to ent> e above entloned'property f , - • ' •
Inspection 717-12--4"
/7_
/ 72-
Signature „� Date a • .' -
Drivers' License or SS# - `-7-
Goldenrod - Assessor DATE: .10/12/33 TIME: 09:34
- - -,ONSTRUCTION AND PLANNING 1 POC SPA
r
APPROVALS Permit#
Efate Inspector APPROVALS Permit# Date Inspector
r't, Temporary Electrical Service or Pole �•' 52. Pool & Equipment Location
.'2: Soil Pipe-Undrgrnd. tif• �� !n 53. Steel-Reinforcement •
fJ ,-3''Electrical Conduit,Utility-Undrgrnd -.' 54. Forms -%'/
•• 4. Electrical Conduit-Undrgrnd. -,r• •? 55. Electrical Bonding 7-
i
5:.Steel,Reinforcement
2. eJ • 56. Rough Plumbing & Pressure Test .y.
a,
`•6. ElectricalUFER'Grnd? 57. APPROVAL TO COVER-GUNITE '
•
7-:'Footings r - 't 58. Electrical Conduit-Undrgrnd. 1; ,..".
8:_ Foundation ' S -�f 59. Gas Pipe, 0 Undrgrnd.,Test
9.'Water Pipe-Undrgrnd. ;^ 60. Backwash Lines,P-Trap, 0 Undrgrnd. 4
10. Structural Floor System t) t� j. 61. APPROVAL TO DECK
11`'Property Sewer Line & House Connection F,- ./f 62. Backwash & Receptor-Final
12. Sewer Cap !;7 1 F'• 63. Heater & Vent-Final - ,4. '
13. Roof.Drains R 1 f-'3 64. Plumbing System - Final
14. Rough Plumbing, �: 65. Electrical-Final !+/
15. Rough Electrical-Conduit - pa .66. Solar System-Final - -•
16. Rough Electric Wiring )2-z-86 i 67. Fencing & Access Approval
i97. Rough Wiring Sign 68. APPROVED FOR PLASTERING
L'11.181. Rough Electrical-T Bar Ceiling- 69. POOL/SPA SYSTEMS FINAL .
.
P. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
O. Rough Factory Fireplace L: s APPROVALS Permit#
•21:,. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating �' 71. Product Piping 0 Gas 0 Oil
•
23/Gas Pipe-Rough & Test 'I'I,/ 72. Underground Flush
24. Roof Framing .1 • 73. Undergrnd.Storage Tank 0 Gas 0 Oil
2E 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 fl 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
' 31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final J , , , ,80. FOOD CERTIFICATE ISSUED
33. Final Electric . ' ' (7fi r/� Notes:
34. Final.Heating & Air Conditioning L U•i
35. Final Gas Pipe-Test \ •
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing /
39. Water Service-Final _ n,,. I
40. Gas Service-Finalk
41. Solar Domestic-Final /,��
42. Backflow Preventer i• • .- 41.:'
43. Backflow Irrigation `j ,IIP
44. Landscape Irrigation System 7 '*
45. Sound Attenuation 1
r
46. Handicap Regulations '
i
- 47. FINAL STRUCTURE & BUILDING •!
48. Snecial Requirements Completed . -
• 49. Electric Release to Edison
150; Gas Release to Southern California Gas Co --, `i(:""
51. CERTIFICATE OF OCCUPANCY - L• i .%• i'•(i� ,4
No. Date 1 r '
i