HomeMy WebLinkAbout1904 RAYMOND AVE - Building Permits •
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA/MESA'CON$TJ3UC ION PERMIT '/ PERMIT NO. TRACT NO. LOT NO. UNIT NO. _
Project Address / ri0 • (•� e/ 3203q f LI - 4386 2/01 /88 ' 20.63 TL
Applicant's M.•ling Address /4- ..2 ij. TYPE OF CONSTRUCTION 1-I NEW U ADD L.1 ALTERATION REPAIR
�{T� `'M�7' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# _ Zone
Owner's Name d•� _ Phpness}--7 kir DESCRIPTION OF WORK/USE OF BLDG.
Address 4. -'• r' - ' 'r Ian.- S Main Building: Accessory Building:
Arch/Eng. r License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION T . O
❑ STRUCTURAL Front
❑ TENANT *ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear _ N
Address ❑ OTHER- - p A
Contractor's Name P) r Phone 1� 3 C Right N
Address(mailing) PROJECT DESCRIPTION SQ. FT. - - OCCUPANCY K Left - G
C ON STRUCTION TYPE VALUATION $ S ,
City License No. ZONE GRADING CU.YDS. ACRES - - R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: A E F E '2-1 O,i 1 Planning Notes: - -
G
with section 7000) of Division 3 of the Business and Professions Code, and M
my license is in full force and effect. T
License Class License No. S
Date Signature PLUMBING FEES
'OR KERS'COMPENSATION DECLARATION •
Bar Sink Showers ELECTRICAL FEES
lereby affirm that I have a certificate of consent to self-insure or a certificate .
�1 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
aCertified copy is hereby furnished. -
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ClarifiersSolar Collec Dishwasher Meter Dover 100 amps .
(This section need not be completed if the permit is for one hundred ($100) or
loss). Dishwasher g Dryers ❑Gas ❑Electric Sub Panel
I certify that In the performance of the work for which this permit is issued, I
shall no employ any person in any ma• er so as t. become subject to he Drinking Fountains So r Tank Fan
WerkeJ�yCogsp`n Laws of Ca if. la. / • �_ Motors ❑0-1 HP ❑1'h-B
Oat%6,�_.6 _-Signature ,/4_ -, 1 -a.#-, SSI -' Floor Drains Swi ing Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP❑16-15+
NO ICE: If,after making this decla a ion, y. should become subject to the /
Workers' Compensation provisions of the .bOr Code, you must forthwith Floor Sinks Urinal Z Fixtures Microwave /
comply with such provisions or this permit shall be deemed revoked. ' 5-6
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Clo tDevice 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 He 2 Outlets ,( Range 'r+
Lender's Name /
Lender's Address Kitchen Sink Water Service / Switches Sign • 1 sr
OWNER BUILDER DECLARATION • 1
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 P Standing 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 •
'he Contractor's License Law(Chapter 9(commencing with Section 7000)of -'
livislon 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
penalty of not more than five hundred dollars($500).
0 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 $ B'
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 A.,
thereon, and who does such work himself/herself or through his or her own Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered for Boiler
sale. S
Lihowever, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date
• elation, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground ,
Building Approved By Date Z
prove for the purpose of sale). {L/. // /grg
0 I, as owner of the property, em exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By r -Y 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, antl 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 off their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT
❑ l am exempt under Section B.& P.C.for this reason ^ Firepl/Fact.Bit. ICBO# 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 00.100,000 BTU 0100,000 BTL (�.7 r GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating totbuilding construction,e and herebyion authorizeprepre-y - MICROFILM $
•
and state
es of rel cityneupon the anand heria property for 7PLAN CHECK 50% §
Inspection • r... s. /.yEO MECHANICAL $ 1 +$ TOTAL FEE $
Signatur- .. /s .� aJ/� L'�'•�Date ID
Drivers' License or # Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 2.0.(p
CMF 0865-46,rev.10/84 white - Building; Canary - •pplicant; 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. 1 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7,Footings 58. Electrical Conduit-Undrgrnd.
8:_Foundation 1 1 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 f/j /9Q_ /�k �r. 67. Fencing & Access Approval .
17. Rough Wiring Sign - r���� 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning 1" FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace `\ APPROVALS Permit# •
�i
21. Ducts, in Structure `4 // 70. Underground Hydro
22. Ducts, Ventilating - 7 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test .t�} �i 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing N744: O4erhead Hydro
,
26. T-Bar Ceiling (Structural) & Monocoat _ 75.7N 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 8/9-% eg* Notesr .
34. Final Heating & Air Conditioning - •
35. Final Gas Pipe-Test .
•
36. Hood or Canopy
r
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 -
- 1
No. • Date _ .
• Applicant to fill in all spaces except those within)heavy bordercilnes and sign all appropriate declarations. . - w
CITU OF COSTA MESA CON$ UCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. • rtl
s /'Parsy�1{��� A8 �m Lc .� 2$t 60 r
.
sect Addr¢3s
Applicant's Mailin Address / _B•r r Z. a. 46, Qj / TYPE OF CONSTRUCTION U NEW U ADD l ALTERATION `REPAIR (1f+1� 1 ••s'
M4 Kc! 4K / &'t Phone SS 2 �g D CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# �i—11f 1` I Zone
Owner's Name la( '- .�.
AlDES IPTIONO...Fppp......WORK/USE OF BLDG. /�sg( Ckt •
Address / #4e4 64 e 'KO otaiQ 71-01,-t. .12 ehoco q� S Main Building: - tilt„ CAccessory B wilding:
E vn l VI VUJIH IrtLJn Z
Arch/Eng. I'' License No. TYPE OF PERMIT IJ GRADING ❑ FOUNDATION ® STRUCTURAL T Front• 0
Address ���e�1 Q i ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL a AB Rear N
Contractor's Name_C�..� N� 'l Aa FI K p P/honelQL�Z�[i ❑ OTHER ® p rE•s 7— s C Right -. N
Address(mailing/ 0 572 Y fG 1.tic^h/ pas3s PROJECT DESCRIPTION SQ. FT. CUPANCYK
CONSTRUCTION TYPE V L ATION$?)Cine '. i. S Left G
City License No. Ar./3t ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION • pr Ping. Ref.# Parking Req./Provided E
1 hereby affirm that I am licensed under provisions of Charter 9 (commenting Remarks: I\e'yOO T- rot ks'1 0.ddl L120 j1 , • Planning Notes: • M
• with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full fore and effect. a! 0� - T
License Class ^ LI ense No. - S
Date/I. 17, 87 Signature pals .PLUMBING - .FE - .
WOR ERS'COMPENSATION DEC RATION :ar Sink Showers \ -
lereby affirm that I have a certificate of consent to self-insure or a certificate - ELECTRICAL FEES
2 Workers' Compensation insurance, or a certified copy thereof (Section B. kflow Preventer Service Sink
A. omatic Washer Transformer 0 15-50 KW
3800, Lab. C.)
Policy No. Company w Irrigation Sewer Cap tion Pole Sub. _ ❑ 50+KW
8 Certified copy is hereby furnished.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Un Meter Dup to 100 am!'
Date Applicant Clarifiers - •
Solar Collectors Dishwasher Meter Dover 100 .
EXEMPTION FROM WORKERS'COMPENSATION DECLARATIONPs
(This section need not be completed if the permit Is for one hundred ($100)or
less). Dishwasher ' Solar Pipint Dryers ❑Gas ❑E . tric Sub Panel
I certify that in the berformance of the work for which this permit is issued,I ,
shall not employ any person in any manner so as to become s bject to the • Drinking Fountains Solar T. k Fan
Dockers-/ ee•-e7
Signa CalifoWia') s•^'7J/2 Motor p41 HP ❑1K-8
Date `` // talo (7 Laws of cal ''FF,,[[�r--{{�� YY�i�r�i((+s���6 Floor-Drains S ming Pool w/Spa ` F.A.U.
NOTIC If,after maks g this declare n, y u should become subject to the - . olar ❑9-15 HP ❑16-15+
• Workers' Compensation provisions o the Labor Code, you must forthwith Floor Sinks ler rinal • Fixtures
comply with such provisions or this permit shall be deemed revoked. _ Microwave
CONSTRUCTION LENDING AGENCY Gas Service ' Outlets W: • Closet Device Boxes
I hereby affirm that there Is a construction lending agency for the performance
e Light
Of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water • er Outlets
Lender's Name - I
Rang•
Lender's Address • ' Kitchen Sink • Water Servic- • Switches
OWNER BUILDER DECLARATION Sign •
1 hereby affirm theta) 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 Standing
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 Generator CO KW 0515 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drai -
the 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 -
nerefrom and the basis for the alleged exemption. Any violation of Section '
•
/031.5 by any applicant for a permit subjects the applicant to a civil _
penalty of not more than five hundred dollars($500).
LJ S
I, as owner of the property or my employees with wages as their sole 'einspection Fee $15 Issue Fee
compensation, will do the work,and the structure is not Intended or offered - — Reinspection Fee f $15 Issue Fee $ 33
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 Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provideq that such improvements are not Intended or offered for Boiler
sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type II 0 , • Zoning Approved ByDate !
oracle n, the owner Will have me burden of proving he/she did not build or im- Duct der Ground //��
prove for the purpose of sale). /
Building Approved By Date /17/8�
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structu Refrigeration System Application Issued By 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 ❑0.100,000 BTU 00.000 BTU SUMMARY OF FEES
builds or Improves thereon,and who contracts for such projects with a con-
tractors) license pursuant to the Contractor's License Law). I am aware that • Exhaust System ❑ Multiple System air/Alteration BUILDING PERMIT $ /S •DO SMTP $ O'sV
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $•
' ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt.ICBO# ' campers PERMIT
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 0o-100,000 BTU 0 a s,s IOBTL -
•
Information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ GRADING $
and state laws relating to building construction,and hereby authorize repre-
sentatives of thit y to enter upon the ova-mentioned property for PLAN CHECK 50% $ MICROFILM '$
Inspection purl �/i •7 MECHANICAL $ /J�• S�
Signature �.i+ Date T-�/'8 7 - TOTAL FEE $
Drivers''u<e e or SS .. s• nspection Fee I $15 Issue Fee 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. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar Systec�-Final
16. Rough Electric Wiring • 67. Fencing &1Access App%val
17. Rough Wiring Sign ' 68. APPRO/UED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling likiiik4%, 69. POO OSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APR RIALS P7rr it# _
21. Ducts, in Structure
70. Undeound 'ydro
22. Ducts, Ventilating 71. Product Pipi Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush 1
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0Oil't
25. Roof Sheathing • 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Moocoat 75. Dry Chemical -
n _
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 i
31. Plaster Brown Coat 79. FINAL INSPECTION - -
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric • Notes: •
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy •
37:. Final Factory Fireplace •
38. Final Plumbing
39. Water Service-Final •
40. Gas Service-Final -
..41. Solar Domestic-Final . '
--42. Backflow Preventer •
43. Backflow Irrigation -
'44. Landscape Irrigation System •
-
45. Sound Attenuation
N
46. Handicap Regulations • •
47. FINAL STRUCTURE & BUILDING /,g % _- , ' 1
48. Special Requirements Completed -• -
49. Electric Release to Edison c
50. Gas Release to Southern California Gas Co ' '
51. CERTIFICATE OF OCCUPANCY
No. Datelik .
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ --
- -...`o.
CITY OF COSTA MESA CONSTRUCTION PERMIT - ' PERMIT NO. TRACT NO. LOT NO. UNIT NO. I r 5785 ' 9/22/87 6440
a Project Address 16104 r.0ND s�,-� ' . .3 30377 - =�
Applicant's Mailing Address 6 / Vt.'eD Li\ 1r TYPE OF CONSTRUCTION LI NEW ADD Li ALTERATION ❑ REPAIR
:/ - ) / -❑ CONVERSION ❑ DEMOLISH OTHER ^7
Dwher's Name q�J"►(_��(��y?''('y/� � �Phone'�---- -��. A.P.# y i-� —a3 I Zone �'
ci
/ �ag ��f�wj •'-'V'� ' DESCRIPTION OF WORK/USE OF BLDG.
•Address j G P rL� �,� Ra �'f - xy(` S Main Building: Accessory Building: •
Z
'Arch/Eng. License No. • . TYPE OF PERMIT U GRADING }�I FOUNDATION NI STRUCTURAL T Front of O
1Address — . . ❑ TENANT ❑ ELECTRICAL LJ PLUMBING ❑ MECHANICAL B Rear 1 / /!/ N
Contractor's Name Ql� Phone ❑ OTHER • A
......./".<.......e
I
PROJECT DESCRIPTION 50. F OCCUPANCY C Right 8/ N
Address(mailing/ 4 K a/2 G
CONSTRUCTION TYPE VALUATION$ 1� $ Left
• City License No. ��/7ts�� ACRES' R
ZONE GRADING CU.YDS. _a(j33..
LICENSED CONTRACTOR DECLARATION Ping. Ref. # PA- 87 -ft•-a Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: - O
with section 7000) of Division 3 of the Business and Professions Code, and M
my license is In full force and effect. - P C C 71— 87 5 T
S
License CIa55 License No. • —
Date Signature PLUMBING FEES _
WORKERS'COMPENSATION DECLARATION — Bar$ink Showers T—
hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES
• f 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 Cohki{g Unit Meter Cup 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 OGas ❑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 •-came subj€ct t• the - r Drinking Fountains Solar Tank Fan .l
Workers' so/npens ion Laws of Cal' 0 • • _, Motors❑D-1 HP ❑1%-S
Y Date Qll/f/iJC Signature ///4, a._AV /e '.ii.. Floor Drains Swimming Poo w/ • — F.A.U.
NOTICE: g this declar. ion, you should become Subject to the Inc.Solar ❑9-15 HP 016-15+
Workers' Compensation provisions of the La•or Code, you must forthwith Floor Sinks Urinal •
• comply with such' provisions or this permit shall be deemed revoked. I I Futures Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets' Water Closet
I hereby affirm that there is a construction lending agency for the performance - Device Boxes POIe Light
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
OWNER BUILDER DECLARATION Switches -Sign I -
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 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 ❑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 . '
herefrom and the basis for the alleged exemption. Any violation of Section
'031.5 by any applicant for a permit subjects the applicant to a civil ,
eenalty of not more than five hundred dollars ($500). •
Ll I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 A..-
compensation,
'compensation, will do the work, and the structure is not Intended or offered - Reinspection Fee I $15 ',Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL FEES
License Law does not apply to an owner of a property who builds or improves .-
thereon, and who does such work himself/herself or through his or her own --_- DEVELOPMENT SERVICES REQUIREMENTS: y� a,�- 9, '7
employees, provided that such Improvements are not Intended or offered for Boiler Hood or Type I ❑ (�( j•Si '2
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 Approved By - Date y6zz�x Z
r ve for the purpose of sale). -
QLJ.($I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 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) °cense pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ '7 B.S0 SMIP $ t7 ••SO
proof off their Worker's Compensation insurance should be provided to me. - - PLAN CHECK $ Zr,03_ PERMIT
_ PE
❑ I am exempt under Section r. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers RMIT ISSUANCE $
PLUMBING $
\ Date Owner eatis , . -f 2 that.. Heating System& Ducting Registers ENERGY P.C. $
d' PLAN CHECK 25% $
i hereby ersfy that I have rto this y it ation and stateco y the above ❑0.100,000 BTU ❑100,0006TL GRADING $
information is c Blatin I agree ut di comply const with all city and y authorize repres ELECTRICAL $
and state laws relating totbuilding tonstructi above-
hereby authorize for MICROFILM $
inspection
of this city to ant: upon the above- gtionetl Pr perty for _ PLAN CHECK 50% $
inspection p eases. ,(
Signature �4,/.. 1..... ft d - •-te 5 MECHANICAL $ TOTAL FEE $ 64.0i
Drivers' L cense or SS#
CMF 0865-46,rev, 10/84 Wh e - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
'CONSTRUCTION AND PLANNING POOL &SPA •
-
ermit# Date Inspector P Date Inspector •
APPROVALS 'P
APPROVALS Permit#
-
r1 LTemporary Electrical Service or'Pole 52. Pool & Equipment Location
t
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 UF ER Grnd. j• . .... IOW 57. APPROVAL TO COVER-GUNITE •
sox jot
7. Footings •''o/C ,z12 /d' , 58. Electrical Conduit-Undrgrnd.
8. Foundation ' ;; /�Z` 59. Gas Pipe, 0 Undrgrnd.,Test ,
9. Water Pipe-Und?rnd. 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 l 67. Fencing & Access Approval
17. Rough Wiring Sign /' 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling / 69. POOL/SPA SYSTEMS FINAL I I1
19. Rough Heating& Air Conditioning 1• FIRE DEPT. REQUIREMENT t.
I
20. Rough Factory Fireplace ' ' /, APPROVALS Permit#
21. Ducts, in Structure 7,0. Underground Hydro
22. Ducts, Ventilating ;:71. Product Piping 0 Gas 0 Oil .,
23. Gas Pipe-Rough& Test •%f72. Underground Flush 'r
f t_
24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas C Oil,t ,
25. Roof Sheathing 74. Overhead Hydro . . I
26. T-Bar Ceiling (Structural) & Monocoat / 75. Dry Chemical �� ./ -.N
27. Frame and Flashing //u/ j C//JJ 76. Dry Standpipe .1
28. Lathing & Siding ViaAfe 77. FIXED SYSTEM FINAL. �.I; .,t
29. Insulation /Lg/r� /y 78. FIRE PREV. FINAL '1
30. Drywall Nailing sem' HEALTH DEPT:/REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION .-1
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE IStSUED r,
33. Final Electric - Notes: N 0 C '\+evel C 11' t-i dZ
34. Final Heating & Air Conditioning /� ' eke '
ettn+ e e ' e k F�r., /Qr '._
35. Final Gas Pipe-Testf
tl tt
3 C.-1 e.t-.•-.... wrest 8ay7Pt c S.T19/
36r•Hood or Canopy 1 IF k
37.,Final Factory Fireplace I �/
lin C� �•� 1=t Com- l/a 1 CO✓Y c/I 1 1-147.
38._Final Plumbing
39. Water Service:Final _ - _
40. Gas Service-Final . - -
4.1. Solar Domestic-Final •
I'42. Backflow Preventer •
_
:43. Backflow Irrigation -.- ��'
„44. Landscape Irrigation System • - `' !• i'
•'45. Sound Attenuation '- i
'n
1'46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING i'
//
- - ' .
48. Special•Requirements Completed l•^ •
49: Electric Release to Edison '1
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY _ .
No. Date