HomeMy WebLinkAbout204 LA COSTA CT - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
��®• t PERMIT NO. TRACT NO. LOT NO. - UNIT NO. '
CITY OF COSTA MESA CONSTRUCTION PERMIT I A
Project Address 2o4 LA cepyr-01 renjer 1).).. ._70,6 !MIS / 4
•'A'pplicant's Mailing �
Address //• 59434JAQT . pro TYPE OF CONSTRUCTION NEW El ADD U•ALTERATION U REPAIR ‘ 11 99 '1/27/87 AF7..l1 TL
C 'U
Owner's Name Y'Lb �rpFT,E4 Pho nettO' 7O)f se-' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ s A.P.#/�•'l� 8Q'l— 0(,�j 09 Zone �l
57cv flea./ DESCRIPTION •F W K/USE OF BLDG. - �I P
A n eefea ./ r .� M•1� - 'S Main Building: Accessory Building:
Address .. z- I
Arch/Eng. lacA. License No. "T-VPE OF PERMIT GRADING 1• FOUNDATION STRUCTURAL T Front 5/ Z0
Address 17 grzi ' - 4LEN / RJI — ❑ TENANT ❑ ELECTRICAL ■ PLUMBING ❑ MECHANICAL B Rear a0, 51 N
Contractor's Name�� i Phone ❑ OTHER �� .•••p��-�.�� � A / • I
,-PROJECT DESCRIPTION SQ. oCC UP1fJrC K .Right '@ 1 /// — G
N
Address lmailing) CONSTRUCTION TYPE I - VALUATION $ 1 S Le
ft 1
City License No. __ ZONE GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION Ping. Ref.# _ al* Parking Req./Provided f ' ' E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' OP .}-)< O''fO _ " G 2 S�' Planning Notes: •
^ M
with section 7000) of Division 3 of the Business and Professions Code, and a �-•-r- D !l ,l J
my license is in full force and effect. I HOLLY I.0[ ^ ,IAL, KLQUIJ tME.lvl E - T
License Class - License No. _ fill S
Date Signature �:. • - PLUMBING - FEES• ` ' vAp iA�
•
'YORKERS'COMPENSATION DECLARATION Bar Sink Showers '
iereby affirm that I have a certificate of consent to self-insure or a certificate - • ' , ELECTRICA FEES
i Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Showaervice Sink ^
3800, Lab. C.)
Automatic Wisher Transformer 0 15-50 KW -
Policy No. Company - Backflow Irrigation - Sewer Cap ' ' ❑,50+ KW ' '
Construction Pole Sub. •
Certified copy is hereby furnished.
Certified copy is filed with c city Building Division. Bathtubs ' Sewer Connection
■ , 100
Date Applicant -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors • Illover 100
(This section need not be completed if the permit is for one hundred ($100) orDish her'
less). -� Dishwasher - Solar Pi p 1n• Dryers 0Gas ■
I certify that in the performance of the work for which this permit is issued, I
olk not employ any person inany ma ners to become subjectto the j-Dlinkmg Fountains-N., Solar • otors 00-n11.111111
Worker o�ina(ly/pn Laws of Calitn ��
Date _ Floor Drains- S. mming Pool w/Spa '_ ■,-15 HP ■
NOTICE:If,a ter eking this declaration, become subject:to the
1615+
Workers' Compensation provisions of the Labor e, you must forthwith Floor Sinks P"Urinal
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service a Outlets: Water Closet • •-
I hereby affirm that there is a construction lending agency for-the performance
vice Boxes ' Pole Light • • ' -
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heat¢!
Lender's Name - _ - -
Lender's Address Kitchen Sink VVater iService •-
. OWNER BUILDER DECLARATION - -
I hereby affirm that Tam exempt from the Contractor's License Law for the Lavatories Auto-Wash . Disposal .'-' I Stbnding 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
any structure, prior to its issuance, also requires the applicant for such permit • -' • - yGenerator •■'- KW ❑5-15 KW Trash Compactor • •
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Dr.' s -
the Contractor's License Law(Chapter 9(commencing with Section 7000) of - .t . r
livision 3 of the Business and Professions-Code) or that he/she is exempt - - - - -
nerefrom 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
' LLenalty.of not more than five hundred dollars($500).
I, as owner of the property or my employees with wages as their sole Reinspection Fee ' li $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 improvesr. 'a
thereon, and who does such work himself/herself or through his or her own - - - DEVELOPMENT SERVICES REQUIREMENTS: v , rZ i,
/
employees, provided that such improvements are not intended or offered for Boiler Hood or Type 0 611 .
sale. If, however, the building or improvement is sold within one year of com- Canopy Type I 0 Zoning Approved By 0/611-6. ate
pletion, the owner will-have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By S Date /•r•
r ve for the purpose of sale).
.as owner of.the property, am exclusively contracting with licensed con- Duct-Structural )frieratios ' ign SyApplication Issued By " /��'�,.�t Date (T-r27-t7
t tors to construct the protect (Section 7044,Business and Professions Code: (J �
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0-100TU ❑100000SUMMARY OF FEEbuilds 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 BUILDING PERMIT: $ £173.00 SMIP - $ 057.
proof of their Worker's Compensation insurance should be provided to me. Exhaust System ❑ Multipletem Repair/AlterationPLAN CHECK $ 7G ' & PERMIT •
-
❑ 1am exempt under Section - B.& P.C.for this reason Firepl/Fact.Blt. ICBGire Dampers PLUMBING $ ISSUANCE. $ _ •
Date LAW1+iii - ��' • Heating System&Duct' Registers ENERGY P.C. $
PLAN CHECK 25% $
I hereby certify that I have read t i . •lication .nd state that the above 00-100,000 BTU 00,000 BTU . ELECTRICAL GRADING $
information is correct. I agree to comply .II cit and county ordinances $ '
and state laws relating to building construction • - hereby authorize repro- • - PLAN•CHECK 50°,6. $ = ' MICROFILM $
sentatives of isstill to enter upon the above-mentioned property
�-for
� _ meq
ins
5ignat "i'p` Date V 11/A7 MECHANICAL $ TOTAL FEE $ 5—‘57A 7(
'•
Drivers' License Reinspection Fee I $15 . Issue Fee $ 3 �I PLAN CHECK 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 Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 203 1 v';*,) 57. APPROVAL TO COVER-GUNITE
7. Footings eL jjf" co I-" 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 21�84 7 61. APPROVAL TO DECK
1,1. Property Sewer Line & House Connection s 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 : ,1.
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
1 ;i
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil ,'
25. Roof Sheathing cf/1/F1 Ott 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical r-
27. Frame and Flashing SR:7 11/ 76. Dry Standpipe -' '_ lc:*
28. Lathing & Siding SASAff s-'j 77. FIXED SYSTEM FINAL
29. Insulation s6/87 &r 78. FIRE PREV. FINAL
30. Drywall Nailing S'hS (� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 6,`/py �� 79. FINAL INSPECTION
32. Electrical Power Meter-Final /"`�[ 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:F�dact +,- ..i4...
�}�7�.//g`7 ('ti� .i.
34. Final Heating & Air Conditioning CIAL REOUIREMENt '
�gA1.D FOR SPE J
35. Final Gas Pipe-Test 1?)N a,/n 'S tOJ uQ4
36. Hood or Canopy ��FF77 L `j"jlll"'��V ttt'�"lll � �""O!
- 37! Final Factory Fireplace ,
38.f Final Plumbing
39. Water Service-Final �` '• '' .,.t
/.
40. Gas•Service-Final -'' '- -
41. Solar.Domestic-Final 1 . 1...$'
(42. Backflow Preventer -- },
a
-43. Backflow,Irrigation "1"1 !`'4
.44. Landscape Irrigation System •'`' i r
•
.45. Sound ,Attenuation , jy
I.
,46.,Handicap Regulations
47-;FINAL-STRUCTURE & BUILDING �1 � W,,, - / •
CA� _ -t i.r•S.. iJ
48!Special:Ae uirements Completed
49. Electric.Release to Edison • . ,' ' ' )
,
50..Gas Release to Southern California Gas Co
51.-CERTIFICATE OF OCCUPANCY ''%I
No. -'Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY. F,COSTA MESA CONSTRU TION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
r - 122 c� 9f- 1349 1 /29/67 490'88 TL
.Project Address 2-nii £4J coat I• �// U •
v Applicant's Mailing.Addres _1p� M&rt//1_et TYPE OF CONSTRUCTION L�7 NEW ADD U ALTERATION U REPAIR (
AN Owners Name t+6/ ! feel Phone XO -90// ❑ CONVERSION ❑ DEMOLISH Cl 0Tr�� q•p.# Zone
Address —�LSe
''// �� CDM DESCRIPTION OF WORK/USE OF BLDG. $ Main Building: Accessory Building:
�`-A
(....\1ArchlEng. -- - - License No. TYPE OF PERMIT El GRADING OjFDUNOATIOry (J STRUCTURAL E Front 0
Address b ` /�/ Q ❑ TENANT ❑ ELECTRICAL LWPLUMBING ❑ MECHANICAL B Rear N
Contractor's Name R _S(.0 z.v (/Vhe7i Phone A‘77_507)..7 ❑ OTHER A I
PROJECT DESCRIPTION SO. FT. OCCUPANCY C Right N
�' Address(mailing) / rrr) �f K G
2Vc CONSTRUCTION TYPE VALUATION$ S Left R
City License No. ZONE GRADING CU.YDS. ACRES
' LICENSED CONTRACTOR DECLARATION s Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: (� 2 24:1 / 1 ^ 3I-r Planning Notes: M
N,S. with section 7000) of Division 3 of the Business and Professions Code, and " �� / nom %L..IQI. z�.7 7 LJ
my license is in full fore an. - ect. v{ (•ti A_ _ T
License lass l.. icense No. U l L VTl c.•G� S
Date - ' Signature + ,� - 40% PLUMBING FEES
WORK RS' OMPENSATION D C A O Bar Sink . Showers '
I hereby affirm that I have a certificate of consent to self-Insure or a certificateELECTRICAL FEES
of Workers' ,cr�ompensation Insurance, or a certified copy thereof(5ection Backflow Preventer Service Sink
—
3800, Lab. ,�.• Q /(� q �J' f Automatic Washer Transformer 0 15-50 KW
Policy No. / C-4a136 - company K�ec -✓t •A'-'I't Backflow Irrigation ,❑ 50+KW
Certified copy is hereby furnished. - g Sewer Cap COnstruotidn POI¢Sub. `
Certifi d py i it .wApplie city Bug g r./ s' ry 3 Bathtubs ( Sewer Connection // hf Cooking Unit Meter El up to 100 amps
Date Applicant //\
EXEMP N F OM ORKERS'C•j ATI N DELL RATION Clarifiers • Solar Collectors Dishwasher • Meter ❑over 100 amps
(This sect on n d not be completed ' the permit is for one hundred ($100) or —
less). Dishwasher Solar Piping 2 7D 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 TankFan Motors 00-1 HP 01%-8
Workers' Compensation Laws of California. -
Date Signature Floor Drains Swimming Pool w/Spa F.A.U. ❑
NOTICE: If,after making this declaration, you should become subject to the Inc.Solar B-15 HP 016-15+
Workers' Compensation. provisions of the Labor Code, you must forthwith Floor Sinks Urinal
comply with such provisions or this permit shall be deemed -revoked. Fixtures Microwave
CONSTRUCTION LENDING AGENCY .1 Gas Service Outlets '' 3 Water Closet I Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance r9 -•
of the work for which this permit is issued (Section 3097 Civ. CJInterceptors / Water Heater 'L—t9 Outlets
Lender's Name Range
Lender's Address / Kitchen Sink / Water Service 'y O Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the ,Q Lavatories Auto-Wash ,(7 °CIStanding
following reason (Section 7031.5 Business and Professional Code: Any city or / Garbage Disposal Sections
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).
o I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
•
compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves - -athereon, and who does such.work himself/horself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. if, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By `/ `` Date
prove for the purpose of sale). Fa.
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By `• 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 ❑0-100,000 BTU ❑100,
000 BTU -
projects builds or improves thereon,and who contracts such with a con- SUMMA•V OF FEES
tractor(s) license pursuant to the Contractor's License Law). I am aware thatIII
BUILDING PERMIT $ SMIP $
proof oftheir Worker's Compensation insurance should be provided to me. Exhaust System ❑ Multiple❑ •
System Repair/Alteration
0 l am exempt under Section - B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLAN.CHECK $ PERMIT
— PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ 7. 3 ENERGY P.C. S .
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 •rrect. I agree to comply wit all city and county ordinances
and state la Ias' to building con u on, and hereby authorize repre-
sentatives s JJ enter e above-mentioned r erty for /'/
inspection r;,
ill
moo - 9 Z 1 MECHANICAL $ 9 .ecce
Drivers'ure �a' F• Date TOTAL FEE $
License or SS Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ •
CMF 0e65-46,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. ,/j/ �y7 J� 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. �7 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. p2//9•2 .ieC 60. Backwash Lines, P-Trap, D Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection j/'{f9 #%',f' 62. Backwash & Receptor-Final
12. Sewer Cap / �/�5// 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing f//c'7 Q/�4r 65. Electrical-Final
15. Rough Electrical-Conduit �'7 // 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 1-,
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 i .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
r
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test ,740 • 0 --1 -.
36. Hood or Canopy / ✓J/�
37.'Final Factory Fireplace e :
38. Final Plumbing _ 7��1/#7"Ar •
39. Water Service-Final / 7�' /' Y , _+
40. Gas Service-Final . . - .• . ' • • -
41. Solar Domestic-Final • ' t-
.,42. Backf low PreventerI . -.- `
,'43.,Backflow Irrigation .. • : •
..44./Landscape Irrigation System ' J
•
1 .
45. Sound Attenuation .-• ' l
46. Handicap Regulations 1
47f FINAL STRUCTURE & BUILDING Al ` .
48'-Special Requirements Completed , #.-- '- • .
49. ,Electric Release to Edison •'1. - `
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. - -
•
CITY OF COSTA MESA CONSTRUCTIONCos-,
tPERMIT PERMIT
�NO. TRACT NO. LOT NO. UNIT NO.
Project.Address 2_ 04 Lit., ` o s-t A . E L 7 g 7 2.
Applicant's Mailing Addreskf k go Gan. V,l 0 g. TYPE OF CONSTRUCTION U NEW U ADO U ALTERATION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER .# Zone
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG.
Address - S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front n O
Address /� r C TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear �7`' "- A "a '3y„�: N
Contractor's Name A AQT M_/k U ` .. +`Phone I
/1.`2���n ❑ OTHER C Right �1, G
p2. r• �lyy J'J % PROJECT DESCRIPTION SQ. FT. -
OCCUPANCY 'Nei
B 1 '
Address lmailing) 1- � Q� 333 `I S� /F' - C ON ST RUCTION TYPE— VALUATION 'S Left �,tA J 1 ''""dd R
City License No. 9 3 S I ZONE GRADING CU.YDS.' � ACRES • Ping. Ref.# "' �� 2b _Pgewmg Req./Provided E
LICENSED CONTRACTOR DECLARATION - a
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /� Planning NOfeS: „- - _ _ N7
•
with section 7000) of Division 3 of the Business and Professions code, and . ` `- G 6 t I y DF STA FSA T
my license is in full force and effect. C
License Class - Lice. e No. _
Date - -• Signature ' /., _ PLUMBING I FEES .
WORKERS'COMPENSATION DECLARATION Bar Sin Showers ELECTRICAL FEE$
I hereby affirm that I have a certificate of consent to self-insure or a certificate /
of workers' Compensation Insurance,.or a certified copy thereof (Section Backflow Pre nter Service Sink CO.
3800, Lab. C.) I Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow Irrigati Sewer Cap ❑ 50+KW I 00
Construction Pole Sub. •
ACertified copy is hereby furnished.
Certified co{�y i filed with the city B 160:7 Bathtubs Sewer Connection Cooking Unit Meter Cup to 100 amps
Date 'S L Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors I Dishwasher / Meter Dover 100 amps cc
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishovdsher • Solar Piping I Dryers ❑Gas ®Electric 1 Sub Panel 0 OC
I certify that in the performance of the work •r which this permit is i ued, I -
shall not employ any person in any m.•ne so s to beep subje• to the Drinking Fountains Solar Tank Fan
Workers' Compggnnsa tion Laws of Califo is _ - Z Motors❑0-1 HP ❑1'h-8 `ZQG
Date t -') o_$ '/ Signature '�d' � ' Floor Drains wimmi • •ool w/Spa • I F.A.U. Inc.Solar ❑9-15 HP ❑16-15+
NOTIC : If,after ma ng this declaration, you shou d bee• e' abject to the a Fixtures Microwave > e'
Workers' Compensation provisions of the Labor Code, you must forthwith • Floor Sinks Uri . - - / - '- 2 as/7
comply with such provisions or this permit shall be deemed revoked. (Y
CONSTRUCTION LENDING AGENCY Gas Service Outlets l ater •set {,� Device Boxes ' •
I hereby affirm that there is a construction lending agency for the performance is Pole Light I
of the, work for which this permit is issued (Section 3097 Civ. C.) Interceptors - Water Heate �"c� Outlets •
Lender's Name _ AZ Range • Ga
- •
Lender's Address - Kitchen Sink 'Wafer Service
OWNER BUILDER DECLARATION 3S Switches Sign '1
I hereby affirm that lam exempt from the Contractor's License•Law for the Lavatories Auto-Wash + �nY��
following reason (Section 7031.5 Business and Professional Code: Any city or 1 Garbage Disposal Standing Sections 1 VC,
county which requires a permit to construct,alter,improve,demolish or repair P-Trap • Laundry Trays • ❑0
-
Generator5 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 [tuft _ •
penalty of not more than five hundred dollars($500). - 3
I, as owner of the property or my employees with wages as.their sole Reins•tenon Fee $15 Issue Fee. —
' compensation, will do the work,and the structure is not intended or offered '' - • Reinspection Fee 1 $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 Zoning Approved B A r y
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0Date
prone n,the owner will have the.burtlen of proving he/she did not build or im- Duct-Under Ground Building Approved By Dat
prove for the purpose of sale).
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued ByX.3144( Date
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 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 P.C.jar this reason Firepl/Fact.BIt. ICBO# Fire Dampers PLUMBING $ ISSUANCE $
Date 1-1 :_t_7_ Owner // I /� Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that have read thismapplication and'st co that the above ordinances 00-100,000'BTU 0100,000 BTC' - •GRADING $
information is correct. I agree to s y plic all city and county the
0 ELECTRICAL $ l{��f,
and state laws relatin to building c tructi and hereby authorize repre-
sentatives of tffykCS a trr//ppnnJJ��r th above-mentioned property for PLAN CHECK 50%. $
inspection purposes i �`�/ 2`T7 TOTAL FEE $ 5 4r is
Signature [� Date 3- CJ MECHANICAL $ f
Drivers' License or SS ' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POS _ A SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1.. Temporary Electrical Service or Poly 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. Sleet Reinforcement: ; ) 56. Rough Plumbing & Pressure Test '
•
6. Electrical UF ER Grnd..• ' 57. APPROVAL TO COVER-GUNITE
7/Footings • � 58. Electrical Conduit-Undrgrnd.
=r
8. 'Foundation i -• j 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd.. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. 'Structural Floor System • I 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
Z
16.,Rough Electric Wiring qr�7 , , 67. Fencing & Access Approval
17.,Rough Wiring Sign �w 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 L,,.. 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 7�-&1 J c. Notes:
34. Final Heating & Air Conditioning - �• '
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gag 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. •
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO.
q TRACT NO. LOT NO. UNIT NO. 5321 4/03/07 2031 El
Project Address 204 LA COSTA COURT t�AOO / ppyy 5320 4/O i/F) I I e❑ 1'
2121 S. GRAND AVE. TVP OF,CONSTRUCTION Q?NEW U ADD U ALTERATION U REPAIR
Applicant's Mailing Address ti
TOM LOVE 642-2901 U CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone
Owner's Name PhoneDESCRIPTION OF WORK/USE OF BDG.
Address 2033 LAURIE LANE r COSTA MA 2k/ S S Main Building: Accessory Building:
E Z
Arch/Eng. License No, TYPE OF PERMIT U GRADING FOUNDATIIOppN�i U STRUCTURAL T Front G
y
Address 0 TENANT 0 ELECTRICAL 0 PLUMBING •t_'4 MECHANICAL B Rear N
SIERRA ENVIRONMENTS k 95I-8491 ❑ -OTHER- A - I'
Contractor's Name on C Right -- N
Address(mailing/ 2121 S. GRAND AVE. ANTA ANA PROJECT DESCRIPTION SQ. FT. OCCUPANCY G
024912 CONSTRUCTION TYPE VALUATION$ S Left R
City License No: ZONE GRADING CU.YDS. ACRES '
' LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided E
1 hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: B27061Planning Notes: • M
- .with section 7000) of Division 3 of 1 h• Business and Professions Code, and _ • T
my license is in full force and eif28. 405194
A License Class f Ns. I • $
'\ Date 3/30/87 Signature: U rAA*1 111 d•% A • PLUMBING FEES —
s WORKERS'COMPENSATION DECLARATI•N / r - -
Bar Sink Showers
1 hereby affirm that I have a certificate of onsent to se -ins e or a certificate ELECTRICAL . .FEES
aof Workers' Compensation Insurance, or a certified .opy thereof (Section Backflow Preventer -- Service Sink- -- - ---
3800, Lab. C.) Automatic Washer- Transformer ❑-15-50 KW
��I Polic No. _ NO1071230WC Co ,an FARMERS Backflow lrti anon I - ❑ 50+ KW
`, Y Y 9 Sewer Cap Construction Pole'Sub.
x_ Certified copy is hereby furnished. / A
Certified copy is filed with the city B .1%7• vis • ' Bathtubs Sewer Connection I • / Cooking Unit •I Meter ❑up to 100 amps
Date 3/10/R7 Applicant II la. I. - — - "
EXEMPTION FROM WORKERS'COM• NSATION • L•R•r N Clarifiers Solar Collectors' Dishwasher Meter Dover 100 amps
(This section need not be completed If th- permit Is for one h ndre• ($100)or - - - -
less). Dishwasher Solar Pipi ! rDryers ❑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 '.nk -• Fan Motors❑D-1 �1h-8
Workers' Compensation Laws of California. -
Date Signature Floor Drains 'lmming Pool'w/Spa • F,A,U. •.
NOTICE: If,after making this declaration,you should become subject to the - Inc.IncSolar 15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - - - Fixtures - - - • Micr•• awe - - ••
comply with such provisions or this permit shall be deemed revoked. _
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes 'ole Light
I hereby affirm that there Is a construction lending agency for the performance9
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets - Range
Lender's Name - ,
Lender's Address - Kitchen Sink • Water Service 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 i 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 Generator 005 ❑5-15 KW Trash Com actor
any structure, prior to its issuance,also requires the applicant for such permit P
to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Dr.' s -
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 •_
enalty of not more than five hundred dollars($500).
LJ I, as owner of the property or my employees with wages as'their solo Reinspection Fee ! $15 Issue Fee - $ 3 •
compensation, will do the work,and the structure Is not intended or offered - - Reinspection Foe I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES '
License Law does not apply to an owner of a property who builds or improves ,
, thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are riot Intended or offered for Boiler Hood or Type I ❑ r
sale. If, however, the building or improvement is sold within one year of com• Canopy Type Il ❑ Zoning Approved By Date
pietion, the owner will have the burden of proving he/she did not build or im- Duct 1 Under Ground •
Building Approved By Date
prove for the purpose of sale).
• 0 I, as owner of the property, am exclusively contracting with licensed con. Duct•Structural Refrigeration System Application Issued By Datee /1
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 0100,000 BTU // 6, SUMMARY OF FEES
builds or Improves thereon, and-who contracts for such projects with a con- Y
Pectoris) license pursuarit'to the Contractor's License Law). I am aware that - BUI LDING PERMIT $ ' $MIP $of their Exhaust System 0 -Multiple 0 System Repair/Alteration
proof 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.Blt. ICBO# Fire Dampers PLUMBING $ ISSUANCE • S
Date owner Heating System& Ducting Registers • PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify'4ha I ave read this application and state that the above 1 11/40-100,000 BTU 0100,000 BTL GRADING $ •
information is correc agree co p y with II city and county ordinances t!0 0 ELECTRICAL $
and state laws relatl o buil ma t trio nd hereby authorize repre- - PLAN CHECK 50% $ MICROFILM $
inspection
ibes of this ci to en e e- entioned Dropert9 fp q
inspection purposes. /II�J' „vl `rU( MECHANICAL $ i/,� TOTAL FEE $ /3 00
Signature Date I l CO
Drivers' License or SS Reinspection Fee $15 Issue Fee • $ 3 PLAN CHECK 25% $ a,Z•
r
CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink -Accounting;Goldenrod -Assessor
•
•
•
•
CONSTRUCTION AND PLANNING POOL& SPA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit#
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, 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
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 ❑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:
•
•
34. Final Heating& Air Conditioning -fp/,r
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. 1 Date . , , •
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF,COSTA ESA CONSTRUCTION PERMITrPER NO. TRACT NO. LOT NO. UNIT NO. 3439 En r/ ,
Project Address LA Cc rid. °I' I ����� 11.13/5—
"`-�'�
Ap+plicant's Mailing Address .... ! L /. TYPE FCONSTRUCTION ❑ NEW DD ❑ ALTERATION Li REPAIR 1
OWner's Nart7p uyt. / hone/ 7eF/s ❑ CONVERSION ❑ DEMOLISH 0 HER A.P.# Zone
L//�_ LavR1E •� DESCRIPTION OF WORK/USE OF BLDG.
Address G S Main Building: Accessory Building:
E • Z
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION STRUCTURAL T Front O
Address DI}�/ ❑ TENANT El ELECTRICAL ❑ PLUMBING ❑ MECHANICAL OTHER B Rear • - N
Contractor's Name 0`//7Phone C Right N
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
Address(mailing) CON ST RUCTION TYPE VALUATION$• S Left i• R
City License No. ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION /� - Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /2 �./ 010I Planning Notes: M
with section 7000) of Division 3 of the Business and Professions Code, and •/ �\
my license is in full force and effect. T
•
License Class License No. S
Date • Signature PLUMBING FEES
"ORKERS' COMPENSATION DECLARATION Bar Sink Showers
iereby affirm'that I have a certificate of consent to self-insure or a certificate ELECTRICAL i FEES
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. 0 50+KW
8 Certified copy is hereby furnished.
•
Certified copy is filed with the city Building Division. Bathtubs . Sewer Connection . Cooking Unit Meter Dup to 100 amps ,
Date Applicant •
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - - Solar Collectors Dishwasher Meter. Dover 100 amps '
(This section need not be completed if the permit is for one hundred ($100) or
-
less). Dishwasher Solar Piping • Dryers ❑Gas DElectric Sub Panel
I certify that in the performance of the work for which this permit is issued, I .
shall not employ any person in any m nn as to become subject to the Drinking Fountains Solar Tank . Fan
Worker 9e Laws of Cali - l Motors El `G
0-1 HP D1 -8
Date Sign Floor Drains Swimming Pool w/Spa F.A.U.Date : If,after_ma<ing this declar ou should become subject to the - , Inc:Solar D9-15 HP D16-15+
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 -.0 Gas Service Outlets Water Closet Device Boxes Pole Li ht
I hereby affirm that there is a construction lending agency for the performance 9
of the work for which this permit is issued (Section 3097 Civ: C.) Interceptors Water Heater ' Outlets
Lender's Name Range
Lender's Address Kitchen Sink . . „ Water Service •
_ 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
following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays
any structure, prior.to its issuance, also requires the applicant for such permit y Generator DO-5 KW ❑5.15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
'he Contractor's License Law(Chapter 9(commencing with Section 7000)of - •
)ivision 3 of the Business and Professions Code) or that he/she is exempt - - -
.herefrom 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). •
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
•
compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL ' I FEES - $ 3
License Law does not apply to an owner of a property who builds or improves f
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 - ZoningApproved B
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 pP y Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date
pr We for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 7S j . '
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 BTUSUMMARY OF FEES -
builds or improves thereon, and who contracts for such protects with a con- - ..
tractor(s) license pursuant to the contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $_ SMIP • $ -
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
0 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO#409147Fire Dampers - g IERMIT $
• PLUMBING $ - _
Date !� �%� 0 n�� Heating System& Ducting Registers - ENERGY P.C: $ -
' I hereby cert y that I have rea• • p-.k•n and state that the above ❑o-100,000 BTU 0100,000 BTL PLAN CHECK -25% $
information is correct. I agree to com• • with all city and county ordinances - ELECTRICAL - $ GRADING $
•
and state laws Blatin to building construction, and hereby authorize repre- - PLAN CHECK 50% $ MICROFILM $
sentatives of is cit to enter upon the above-mentioned pr perty for • �T
inspection per =1•se -' n /•�Nn I MECHANICAL $ TOTAL FEE $ 13- -oO
Sign. �1ts. ` Date ' '�L Reinspection Fee $15 taus Fee $ 3 PLAN CHECK 25% $ 0
Drivers -
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor -
CONSTRUCTION AND PLANNING . POO L& SPA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms t,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ,
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test '
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE /
I
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation • 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing • 65. Electrical-Final '
15. Rough Electrical-Conduit •66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning I 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 4 .
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
26. T-Bar Ceiling.(Structural) & Monocoat 75. Dry Chemical •i:-,,
27. Frame and Flashing 76. Dry Standpipe ,
28. Lathing &'Siding i 77. FIXED SYSTEM FINAL . :`./•
29. InsulationC.' 78. FIRE PREY. FINAL
30.. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37? Final Factory Fireplace - f/401 fin 4
38!Final Plumbing •
39'. Water Service-Final t"ei'
40. Gas Service-Final .
• • /?-'y
41. Solar Domestic-Final
42. Backf.loW Preventer ' 1 it'
I s.
43. Backflow.Irrigationt�1 .9 -- j
44. Landscape"lrrigation System ; ' i1'
'45. Sound Attenuation
1..46. Handicap Regulations 1/ ;:,
47. FINAL STRUCTURE & BUILDING
r i7
48.,Special.Requirements Completed /I:. :4'I.,
49. ElectriO-Release to Edison
50. Gas Release to Southern California Gas Co •
51. CERTIFICATE OF OCCUPANCY ✓ .
No. -`Date - •