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Home My WebLink About2481 IRVINE AVE - Building Permits • CITY OF COSTA MESA Fq BUILDING DIVISION FISI 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us - " FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: B11-00151 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 93401006 DATE ISSUED: 05/06/2011 ISSUED BY: RMD JOB ADDRESS: 12¢81rF;IRVINE;AViCM.i e }'".,'4 Suite/Unit: F Vicinity: 2ND FLOORROOF - - 1 Squares: 700 Valuation: $1,300.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS AND INSTALL NEW TORCH DOWN ON 2ND FLOOR FLAT ROOF AREA, APPROX 7 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED.COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment wlInspection Card OWNER: STOVALL DIANE I Address: 2481 IRVINE AVE Unit: UNIT F PHONE: 231-749-9938 City/State/Zip: COSTA MESA,CA APPLICANT: RODRIGUEZ,MARTHA Address: A •, . Unit:\ : • PHONE: 213-216.8218 City/State/Zip:�� . . CONTRACTOR: SOUTH WEST ROOFING CO License No. 626921 Address: 3912 S GRAND AVEUnit: PHONE: 213-446-4677 City/State/Zip: LOS ANGELES CA 90037 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $47.90 • Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $48.90 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/16/2010-PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No. 92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE r, INSPECTION TYPE GATE IN1TAL$ CODE r INSPECTION TYPE DATE INTnIAI$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final yy� 208 Final Plumbing 1 200 Final Re-Roof b II— II I' 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition w\' 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: rOwner ID verified by drw, •(cense. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: i ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,tor the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are' , person is required to descend,will be made in connection with work authorized Carrier:are_. �� r by this permit,and that no building structure,scaffdding,falsework,a demolition (This section need ndbeWTnpletepathe permit a vaFied as cos hundred dollars(510o)or less.) or dismantling thereof,wilt be more than thirty-six(36)feet high.(Chap.3.2.Grp 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: �� 7 --.-VECC 63 S'- 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this'permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,Ish forthwith comply with these provisions. i / / Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full/force and effect. �4 . a registration form for acutely hazardous materials? 0 Yes 0 No ¶ Lic.# ' in4 ' 2 Class# ? % (Section 25533 of the California Health and Safety Code, with some i/ � exceptions, requires registration with the Costa Mesa Fire Department by + each business which at any one time has on hand a quantity of acutely trot's Signature ,Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work fa which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish. or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. property, ❑ I, as owner of the LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city • ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. re" Legalowner(s) Date Signature Date �j �'— /4 3057'46(3107) dlor Authorized Applicant Date CITY OF COSTA MESA �4 BUILDING DIVISION A a .,�' 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us TA- FOR INSPECTIONS CALL:(714)754-5626 w "'Aad l PERMIT NUMBER: P09-00004 PERMIT TYPE PLUM STATUS: ISSUED APN: 93401006 DATE ISSUED: 01/07/2009 ISSUED BY: CAC JOB ADDRESS: 2481 IRVINE'AV CM ' .t Suite/Unit: :., ':; Vicinity: SCOPE OF WORK: REMOVEAND-REPLACEEXISTING WATER HEATER AT THE SAME LOCATION ,) • • - , OWNER: STOVALL, DIANE 1- ; •Address: . 2481 IRVINE.AVE#F PHONE: 949642-6898• - ' '�. - - '-City/State/Zip: COSTA MESA;CA APPLICANT: BYRON MAZARIEGOSt> - r. - -• Address: 24707 SAN'FERNANDO.RD. : PHONE: 6614597131 --. - - ' City/State/zZip:• ;--SANTA CLARITA,CA CONTRACTOR: AFFORDABLE WATER HEATERS AND PLUMBING License No. 627368 . • Address: 24707 SANFERNANDO RD - _ PHONE: 661-259.7131' City/State: SANTA CLARITA,CA . ZipCode: 91321 CELL: ARCHITECT: License.No. - PHONE:• ENGINEER: License No. - - PHONE • PLUMBING. PERMIT FEE SUMMARY PLAN CHECK'FEE:' PERMIT FEE: $35:80 's • TOTAL FEES: - $35.80 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. gat INSPECTION TYPE PATE INITML$ CODE( INSPECTION TYPE DATE INnfAts 1818 Fixed System Final Fire Prevention 206 Final Mechanical �1 1266 Pool Spa Final 208 Final Plumbing .1-•Z4—°i 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: ' Owner ID verified by drive. _.,cense. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver s.License No. Expires: • 0 I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for,by section 3700 of the Labor Code, for the • . • pert mance of the work for'which this permit is issued. I have and will maintain workers'compensation insurance,as required by s tan 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: sued. My workers' compensat(on Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a i / 7—e441 f // person is required to descend,will be made in connection with work authorized o/(�'/'.di �d/moi,w."r,�L/f by this permit,and that no building structure,scaffdding,falsework,or demolition • or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This ar not be mmpleted"the perm4iissvvat at one anundredddrars(El 00)a less.) 2,Art 2,Sec.341,Title B.California Administrative Code). P ' y tuber 20 �f� _`� 7�'� ❑ As owner-builder, I will not employ anyone to do work which would I that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued.I shall not employ - • .erson in any manner so as to become subject such person has a permit to do such work from the division. to the workers' cam.-nsatio .ws of California, and agree that if I should • become subject to e works, , comp- sation provisions of Section 370 of the Lab. ode,I s ort cop with these provisions. Applicant's Signature Dale 'st-o/ c� / Division of Industrial Safety Permit Number: Ig�*/ Dat HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FR LUR' TO SE.TRE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file yn.-. se is in full force and fieeffect. T�.. ) /��. a registration form for acutely hazardous materials? 0 Yes ❑ No 01, / z �0 ClaksaY ✓ k. (Section 25533 of the California Health and Safety Code,. with some exceptions, requires registration with the Costa Mesa Fire Department by ./ /! 7 each business which at any one time has on hand a quantity of acutely ��1j��,Cclie- ' to hazardous materials equal to or greater than a weight of 500 pounds, or a /tea volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION.4 '• AGENCY: temperature and pressure). ❑ I hereby a irm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 651750.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications fa non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No thereon,and.who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE:'I certify that under'penalty of perjury the did not build or improve for purpose of sale.). r . information,given above is.correct. I agree to comply with all state laws.and • city ordinances regarding Hazardous Materials and Emissions. ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH ' LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Dale property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penally of perjury that I have read this application and state that CI I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason:. • the City of Costa Mesa to enter upon the above-described.property for inspection purposes. I agree not to occupy or allow occupancy of any building ' authorized by this permit until final inspection. • . • - • Signature,:^F. ter(s) sale • Signature ' ' Date - ia. - L7 ) r 3057-46(3/07) A ./o re. ,Li.;nl .7IIIIir • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - - PERMIT NO. - TRACT NO. LOT NO. - BLDG.NO. - - CONSTRUCTION PERMIT jdfa�S�� 8272 4/09/64 5.00 TL Project Address - _ .. . a - A" • TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION, LI REPAIR - r Applicant's Mailing�udre ❑ CONVERSION CI DEMOLISH CI OTHER (Zone • A-P,# DESCRIPTION OF WORK Owner's Name /' C �.,,,'h�on yy7,, S Main Building: Accessory Building: Z Address a1) ,2 t-'/ - tx,�.(�v�LvQQ' f E - 0 TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front N Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICALB Rear I A N • Address n ,�-1" " ,, r(, ❑ BOTHER • C Right G /�,C ,.//((,(�-,~•=r eS47-TJalb PROJECT DESCRIPTION SQ. FT. OCCUPANCY R Contractor's Namr /C/J7J_' - /" s��P�hon /� K Address(mailing)/7�� 5" --j/ S 1`t •CONST RUCTION TYPE VALUATION$ _ $ Left E 3d�C/1 (/ 4T oZ-7p7 • ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park.Fees $ G City License No. (S:.J c� U LICENSED CONTRACTOR DECLARATION Remarks: Parking Rect./Provided I'hereby affirm that I am licensed under provisions of Charter 9 (commencingR - with section 7000) of Division 3 of the Business and Professions Cotle, andUse of Building: _ my license is in full rce4nd effect. • License Class ice o. • S PLUMBING FEES Planning Notes: M Date2Ja , Signature -:L SP - E Bar Sink Showers N ` ; WORK RS'CEIMPENSATION DECLARATION. ' , O T hereby affirm that I have a certificate of consent to self-insure or a certificate ' Backflow Preventer Service Sink S I-Workers' Compensation Insurance, or a certified, copy thereof (Section - -- - - ' - - 3800, Lab. C.) Backflow Irrigation Sewer Cap -' ELECTRICAL FEES Policy No. Company - - - Bcertified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer: Transformer ❑ 15-50 KW Certified copy is filed with the city Building Division. - ❑ 50+ KW Date Applicant Clarifiers Solar Collectors Construction Pole Sub. . EXEMPTION FROM WORKERS'COMPENSATION DECLARATION � 7 Dishwasher= ) /� - Solar Piping - -- - - - - Cooking Unit - _ 1, - 'Meter Dup to 100 amps ' - (This section need not be completed if the permit is for one hundred ($100)or l ( / o•1r _ less). \ -Dn n Fountains - /x I certify that in the performance of the work for which this permit is issued' I 9 Solar Tank Dishwasher Meter Dover 100 amps shall not employ any person in any manner so as to bgggc��-ome subjec to the , Workers' rypen ttii�on Laws of California-z/ !Y Floor Drains. Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel , Date /ate `(4- Signature /7 l' NOTICE: If,after aking this declaration,you should become ubje o the Floor Sinks • Urinal Fan Motors❑O.1 HP ❑1X-8 Workers-Compensation provisions-of the Labor Code, you must forthwith , -- 'f - - - - - - - comply with such provisions•or this, permit shall be deemed revoked. - IGas Service i Outlets Water Closet F,A,U. ' .Inc.Solar.❑9-15 HP ❑16-15+ CONSTRUCTION LENDING AGENCY • - I hereby affirm that there is a construction lending agency for the performance • Interceptors' - Water Heater Fixtures :Microwave of the work' for which this permit is Issued (Section 3097 Civ. C.) - , Lender's Name - Kitchen Sink - Water Service ' . Device Boxes Pole Light • Lender's Address Lavatories - • • OWNER BUILDER DECLARATION _ - ' ' . Outlets Range I hereby,affirm that I am exempt from the Contractor's License Law for the P-Tra , following reason (Section 7031.5 Business and Professional Code: Any city or. , P Switches . Sign county which requires a permit to construct,alter,Improve,demolish or repair - •any structure, prior to its issuance, also requires the applicant for such permit . Roof Drains . - - Garbage Disposal Standing Sections '- .to file a signed statement that he/she Is licensed pursuant to the provisions of - • 'the Contractor's License Law(Chapter 9(commencing with Section 7000) of - - . • Generator CO-5 KW❑5-15 KW Trash Compactor (vision 3 of the Business and Professions Code) or that he/she is exempt S erefrom 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 Reinspection Fee I $25 Issue Fee - $ 3 onnalty of not more than five hundred dollars($500). $ 3 I, as owner of the property or my employees with wages as their sole • Reinspection Fee $25 Issue Fee compensation, will do the work,and the structure is not intended or offered ' MECHANICAL FEES - - f. for sale (Section 7044, Business and Professional Code: The Contractor's ®- - - - - - - - - - - - - - - -® PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I ❑ thereon, and who does such work himself/herself or through his or her own Zoning Approved By nate • employees, provided that such Improvements are not intended or offered for Canopy Type II ❑ sale, If, however, the building or Improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date / �// pletlon, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By Date U I, as owner of the property,am exclusively contracting with licensed con- ❑0.700,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES , The Contractor's License Law does-not apply to an owner of property who ; BUILDING PERMIT $ SMIP builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple❑ System Repair/Alteration $ tractors) license pursuant to.the Contractor's License Law). PLAN CHECK • I $ C PERMIT ❑ I'am exempt underSection - - B.& P.C.for this reason Firepl/Fact.Blt. (CBO# PLUMBING $ - �'�� ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ Date Owner Heating System& Ducting , - I hereby certify that'I have read this application and state that the above 0o-100,000 BTU ❑100,000 BTI.: - ELECTRICAL $ GRADING • $ Information is correct. I agree to comply with all city and county ordinances - and state laws relating to building construction,and hereby authorize repre- - PLAN CHECK $ - MICROFILM ; $ sentatives of this city to ent r upon the above-mentioned p'opert� for - inspection purposes. j/ `/A- Signature • �.l " "�' "� Date �� T - MECHANICAL $ TOTAL FEE $ �' Drivers' License or SS lr - Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ • CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod --Assessor - - - - - - -- -- -- - - . - ._ - - - - I •- CONSTRUCTION AND PLANNING POOcESPA • - *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. 10.1 Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12.E 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 2'4. Roof Framing 73. Undergrnd.Storage Tank 0Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat- 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL , 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy - 37. Final Factory Fireplace 38. Final Plumbing 'J//fkj LCD 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 - -t 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOF,OCCUPANCY . • 1 No. Date