HomeMy WebLinkAbout2019 Tustin Ave - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
PER 1. • IWC. LOT NO. UNIT NO.
CITY Of COSTA MESA CONSTRUCTION PERMIT �y.•�%;�,y��,-;,) P 9508 4/29/8 : son:, TL
Project Address �n 19 Tu Sri �/\/1 r��/-/--•- =- 33a(6'6
*Applicant's Mailing dress 1S33 ')j. I.._iy c L'y..t� TYPE OF CONSTRUCTION U NEW LJ ADD U ALTERATION U REPAIR
CI CONVERSION ❑ DEMOLISH CI OTHER A.P.# _
,S 57�
Zone
Owner's Name C ✓AJ Phone DESCRIPTION OF WORK/USE OF BLDG.
Address X�rnc —
S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL T Front O
Address --/'' 6 Gn p .,,.sem ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name! C+/y/c e.S �//)/M)'1-SPhone Q9a it ❑ OTHER A •
PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(mailing) ./S3 3 lel NCOL-�:J K G
S(1 CONSTRUCTION TYPE VALUATION$ S Left
R
City License No. -1 ZONE GRADING CU.YDS. ACRESE
LICENSED CONTRACTOR DECLARATION • Plug. Rel. Parking Req./Provided
Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: 1'T 188 M
with section 7000) of Division 3 of the Business and Professions Code, and RECEIVED MAR Z T
my license is in full +rc• . d effect. i �/�C s�
Licens Cla s - V ic- .e No. J j S
Date - -.21... Signature SW_ . _ /�4. : PLUMBING FEES RECEIVFO APR 2 I WR
"h"'ORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES
o8ereby affirm that I have a certificate of consent to self-insure or a certificate
Workers' Compensation Insurance, or a certi led copy thereof (Section Backflow Preventer Service Sink
800, Lab. C.) a i/rte,/, Automatic Washer Transformer 0 15-50 KW
1 Policy No. `,/Li Company irpi/E/t JA 33 Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
v�-Ul �,€er lifted copy is hereby furnished.
Da Cert' ietl o3 �s tiled with the city 130,9 9iyillo Bathtubs Sewer Connection - Cooking Unit Meter Dula to 100 amps
Date � Tr Applicant WC 1i
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not bo 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 manner so as to become subject to the Drinking Fountains Solar TankFan Motors❑O-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 016-15+
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
comply with such provisions or this permit shall be deemed revoked. _ Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance !l Pole Light
of the work for which this permit is Issued (Section 3097•Civ. C.) Interceptors ) Water Heater r�p)(J 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 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 ❑O-5 KW 05-15 KW Trash Compactor •
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
'ivision 3 of the Business and Professions Code) or that he/she is exempt
erefrom and the basis for the alleged exemption. Any violation of Section
Ps1.5 by any applicant for a permit subjects the applicant to a civil
• ' natty of not more than five hundred dollars($500). 3
f \ ) I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $
- -compensation, will do the work, and the structure Is not intended or offered Reinspection Fee 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:
Hood or Type provided that such improvements are not intended or offered for Boiler I ❑
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date 4 �4 r
pletlon, 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). --= "•
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By o� 3 Dat= ;�=!',f�--
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 ❑ Multiple❑ System Repair/Alteration BUI LDING 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.Blt. ICBG# Fire Dampers J PLUMBING $ �Q ISSUANCE $
Date Owner Heating System& Ducting Registers ENERGY P.C. $
_ PLAN CHECK 25% $
I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BT GRADING $
Information Is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to nter upon the above-mentioned property for ,�+�®
inspection purp �j
Signature Date) GGJ f/// MECHANICAL $ TOTAL FEE $ 5
+
.Drivers' License or SS# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
.. .....:...,.„.,A
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
•
/I
1
CONSTRUCTION ANDCRLANNING POOL& SPA
Date Inspector "Date Inspector
APPROVALS Permit,#--- APPROVALS Permit#
1. Temporary Electrical t j_rte e or Pole 52. Pool & Equipment Location
2.' Soil Pipe-Undrgrnd. v 53. Steel Reinforcement n
3. Electrical Conduit Utility-Undrgrnd. 54. Forms -.. ?'
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding in .
5. Steel Reinforcement 56. Rough Plumbing & Pcpisure Test
6. Electrical UFER Grndc,, 57. APPROVAL TO COVE -GUNITE
7. Footings '1;(.2 58. Electrical Conduit-Ur-141:Z. ,
8. Foundation` 59. Gas Pipe, 0 Undrgrnd;tat
9. Water Pipe.Undrgrndy 60. Backwash Lines,P-Tra1L,(6 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK'i"7 .
ly
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 O 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 ri•, 1
28. Lathing & Siding 77. FIXED SYSTEM FINAL • x
•J.
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT %".
.
31. Plaster Brown Coat 79. FINAL INSPECTION rr'r
7
.
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED"-,
•
33. Final Electric Notes: • •j;" Y
34. Final Heating & Air Conditioning '^" "
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace ' /
38. Final Plumbing (�8r La .
39. Water Service-Final 7 - ,
40. Gas Service-Final
41. Solar Domestic-Final '
42. Backf low Preventer - ' •
43. Backf low 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 = I C. - _ _ 1
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarat[Ons.
MESP CONSTRUCTION PERMIT PMIT NO_ TRACT NO. LOT NO. UNIT NO. `
ICITV OF COSTA 2019 Tustin Ave C.M. 1' Z P $ 50
l�,.t ddress `�
126 Commercial Way C.M. c 2YY��OF CONSTRUCTION LI NEW Li ADD Oct ALTERATION LI REPAIR
Applicant's Mailing Address p C LTJ
Barbara Baily Phone 642 036E CONVERSION ❑ DEMOLISH ❑ OTHER A P # Zone
Owner's Name 2025 DESCR,J PT ION OF WOR C USE OF �LfZG�r ^
Address Comodore Rd N. B. Croo fl�/_I-- '- vi S Main Building: Accessory Building:
E Z
Arch/Eng, - License No. TYPE OFPE PERMIT GRADING tiJ FOUN ATION STRUCTURAL T Front O
El TENANT ❑ ELECTRICAL. ❑ PLUMBING ❑ MECHANICAL
Address B Rear N
DOntrar.(Of'S Name i Phon4 ❑ OTHER A I
Grp-Ilse—Bros .Roof — 9 PROJECT DESCRIPTION SQ. FT. 1900 OCCUPANCY mII I� C Right N
Address lmailingl�-6 Cnmmerri al Wy C M q? 7 K G
CONSTRUCTION TYPE garages VALUATION 2_, 385 00 s Left
City License No. 005993 • R
ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I herebyaffirm that I am licensed underprovisions of Charter 9 (commencing0
Remarks: Planning Notes: M
with section 7000) of aDivisionof 3 of the Business and Professions Code, and
my license is In full force and effect T
LicensenCls9yo- S9 Lice (6� S
Date UO�/ O Signature 42.S -ee PLUMBING FEES
WORKERS'COMPENSATION D RATIONBar Sink) f
1 hereby affirm that I have a ce cate of consent to self-Insure or a certificate Showers -• ELECTRICAL FEES
lar/� of\Workers' Compensation I ranee, or a certified copy thereof (Section
Service Sink
Ml. 38p0, Lab. C.) Backflow Automatic Washer Transformer 0 15-50 KW
''\����.1-is--o�lig�yY No. _2_85_.42_2 4-8-7_ Company/tate L'un . Sewer Cap Construction Pole Sub. 0 50+KW
4,tertified copy is hereby furnished.
dddZ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps
Date__g f_ _/8'/ Applicants-a- —Br-os . Roof-i�+g�co
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION --b Clarifiers Solar Collectors Dishwasher Meter Doer 100 amps
(This section need not be completed if the permit is for one hundred ($100)or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tan Fan Motors ■e HP DIA-8
Workers' Compensation Laws of California. _
Date Signature Floor Drains Swi Ing Pool w/Spa F.A.U.
NOTICE: if,after making this declaration, you should become subject to the _ In :•lar 09-15 HP 01615+
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks rinal Fixtures
comply with such provisions or this permit shall be deemed revoked. _ Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet
I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole 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 SinkWater Service
OWNER BUILDER DECLARATION Switches Sign
I hereby affirm that 1 am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Di ..sal
following reason (Section 7031.5 Business and Professional Code: Any city or 9 Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00-5 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 • ,
nrefrom and the basis for the alleged exemption. Any violation of Section
• 11.5 by any applicant for a permit subjects the applicant to a civil
alty of not more than five hundred dollars($500). �—
', as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ .
1 3 pensation,swill do the work,and the structure Is not intended or offered Reinspection Fee $15 Issue Fee $ 3
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 I DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0
sole. 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). ey
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By a ✓2L7'-(JT
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 B 0100,000 BTU SUMMARY OF CrF S
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 Syste ¢pair/Alteration - BUILDING PERMIT $ /9- Ott SMTP $ 'ii- .."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.Blt. ICBG# ire Dampers PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY PG: $
I hereby certify that have read teishrpli,anon and state that the above 00-100,000 BTU 0100,00 U - ELECTRICAL GRADING $
information is correct. I agree to cam- wi all city and county ordinances $
and state laws rel. g to building ••. ruc ion, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this y to enter fh: ab Ove-mentioned rope r
Signainspecture
purpose' / I`-1 / `1 Date MECHANICAL $ TOTAL FEE $ /1'.JTJ
Signature L.A.��
Drivers' License or reiv Reinspection Fee $15 Issue Fee • $ 3 , PLAN CHECK 25% $
CMF 0865-46,rev. 1/ 4 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 Systein-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 p.
tt
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 't
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
46. Handicap Regulations
47. FI NAL STRUCTURE & BUILDINGQ/y7/g7
48. Special Requirements Completed < ts�
49. Electric Release to Edison /
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date /
L
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. /0 '/0-FJ
CITY OF (\OSTA JIIESAA C NSTRUCTION PERMIT • PERMI NO. TRACT NO. LOT NO. UNIT NO.
. Project Address 0`9/ / _S/ ,�I l a � yes r1 3317 10/31 /85 bn�' fl_
Applicant's Mailiyn ,Address /33 3 lr/ E%.t1ea!))/Ai TYPE OF CONSTRUCTION LJ NEW U ADO U ALTERATION ❑ REPAIR l
Owner's Name /0n? el*/0/ Phone/me 1,Le2-`3vy III CONVERSION ❑ DEMOLISH ❑ OTHER A,P,# Zone
DESCRIPTION OF WORK/USE OF BLDG.
Address �j q ((491-5- einmC Ct^,o l,( /Memop 1- e_Car. h E Main Building: Accessory Building:
li Arch/Eng. License No. TYPE OF PERMIT CI GRADING ❑ FOUNDATION III STRUCTURAL T Front Z
J� O
Address G / �I '/ ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N
Contractor's Name-Re bAY/S Pit/m✓1444 _ f"phone-/1,1--54L70 ❑ 'OTHER -._--- -
y 533 /+ 1 rR PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Addresslmailin I /�i�tf'-43 /iP.hP/M 90)PO K G
CON ST RUCTION TYPE VALUATION $ S Left• R I
City License No. J_/6.3 V • ZONE GRADING CU.YDS. ACRES - E
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided Q
(p I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
+ with section 7000) of Division 3 of the Business and Professions Code,and T
my license is in full forceland effect. _mss
Licens/C/C1lass /. ".3-/%' '
Lice se�Plo rT^/7&S / $ 1
Date/V 10—'r Signature -- ,17." -4 '7J •
PLUMBING FEES 'i�
QWORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL Fl 1-
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 Preventer Service Sink - --
3800, Lab. C.)
Automatic Washer Transformer 0 15-50 KW
Policy No, D4FXS-0 Company-Zee✓e- K /-41-5-- Backflow Irrigation Sewer CapLI 50+ KW
Construction Pole Sub.
(Certified copy is hereby furnished.
certified copy I filed with the city B Itlinq l isioJ�� Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date /n-10-.-r APPlicant�a/ldln y A./ ell-afc,
EXEMPTION FROM WORKERS'COMPENSATION DE6LARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps ,
(This section need not be completed if the permit is for one hundred ($100) or I
less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I
I certify'that In the performance of the work for which this permit is issued, I -
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%.8
Workers' Compensation Laws of California.
Date Signature • Floor Drains Swimming Pool w/Spa • F.A.U. Inc.Solar 09-15 HP 016-15+
NOTICE:If,after making this declaration, you should'become subiect to the — - — ,
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked. '
CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet tI
I hereby affirm that there is a construction lending agency for the performance ,{ Device Boxes Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors ( Water Heater - _L o(� I Optlets Range
Lender's Name 6'
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
/ r Garbage Disposal !Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry
any structure, prior to its issuance, also requires the applicant for such permit Trays Generator 00-5 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 —
therefrom and the basis for the alleged exemption. Any violation of Section • I
7031.5 by any applicant for-a permit subjects the applicant to a civil 1
penalty of not more than five hundred dollars ($500). $ 3 %, I
L i i,- I as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee
compensation, will do the work, and the structure is not Intended or offered - / Reinspection Fee I $15 Issue Fee $ 3 I
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 ❑ 9,
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 B'a(ding (�/l //
Approved By Date
'I prove for the purpose of sale). O-.4/ f.�
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System ApI plication Issued By V.J./ Datn -
tractors to construct the project (Section 7044,Business and Professions Code: ,n
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU ❑100,000 BTU t / ( SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con- I �,_ BUILDING PERMIT $ SMIP $
tractor(Si license pursuant to the Contractor's License Law). I am aware that ' Exhaust System ❑ Multiple❑ System Repair/Alteration _
proof o/ their Worker's Compensation insurance should be provided to me. !,PLAN CHECK $ ry PERMIT -6-,-.4. /'
❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers ,PLUMBING $ 1�' ISSUANCE . $
Date . Owner Heating System& Ducting Registers f `PLAN CHECK 25% $ ENERGY P.C. $ l
I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100.000 BT GRADING $
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $
and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city to enter upq"A the above-mentioned property for \ f,
J inspection 4 V 10 45 ,(6 /O�C et- MECHANICAL $ TOTAL FEE $ S A-(!
Signature`/L se . /it-7n.. Date $
Drivers' License or SS ( Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% s
-1
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#
.�. 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 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 1110il
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
31. Plaster Brown Coat - 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric • - Notes: TA fi,8
34. Final Heating & Air Conditioning LL ( j
• �'1L r3G I n tio i aY
35. Final Gas Pipe-Test • 3
36. Hood or Canopy �Ji
37. Final Factory Fireplace 'f
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 G Co •
•
• 51. CERTIFICATE OF OCCUPANCY
No. Date