HomeMy WebLinkAbout276 20TH ST - Building Permits111111.1r—
d. PROJECT ADDRESS: 276 E 20TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 056794
-OrvER's NAME: WHELAN JOHN F
ADDRESS: %WHELAN PROPERTY MGNT PERMIT NO: B 056794 PLAN CHECK NO: N GOVT: N SUPP: N
3140 REDHILL AVE #150
COSTA MESA, CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: REP
540-3666
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF PART REROOF 6 REPAIR RAFTERS SQ FT: 2, 500
ADDRESS: UNIT:
CLAIM VALUE: 2, 500. 00 CALL—VALUE: 2, 500 .00 GROUP OCC: R-1 /
PERMITTEE: FERRARA ROOFING ( 714 ) 642-8233
ADDRESS: 3013 GARFIELD COMMENTS: REROOF 6 REPAIR " FIELD VARIFY"
COSTA MESA CA 92626 *******+E************************+t****************************************Tt+t****
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: O 6798 STATELIC.: 342740CLASS: C—,39 /
Date: 5 Vt..— Signature: tat. / MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to sell-insure or a certificate of Workers' FENT: FT IN REAR: FT IN FENT: FT IN REAR: FT IN
WORKERS COon PENN ifieAaION:pyt thereof(Section 3800.Lab. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
-CY NO.: f4��� �' Jj EXP.DATE: 87/01 /92
JAPAHY: STATE FUND PARKING REQ PROV: PARCEL: 42621117 ZNE: REF NO:
0 Certified copy is hereby furnished. C Certified copy is fit d with the city Builtli g Divis"n. PLANNING NOTES>.
'11. >
--- Date' y /f f (i• Applicant: GV?.T,e ************.********************************************************-* *********
EXEMPIIO FRofn WORKERS'COMPENSATION DECLARATION: (This section need not be competed it the perm*is or one hundred($100)or less). DEV E 'L O P M E N T SERVICES R E Q U I R E M E st7, S
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 • G,.
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE;
Date: Signature:houBUILDING APPROVED BY : G-7 t,i /i — ,�eLD l/,o'Rdr7c4770� DATE K.
NOTICE:II,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. .• I - h pt.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION :ISSUED BY. � = DATE: Of-+(/ / Z
which this permit is issued(Section 3097.Civ.C). ***********}E*Ok.******** ************ ** ******
LENDER: ************************************ *****************************4E$3*********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL; SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason • BLDG PMT PLUMBING ELr TRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter.improve,demolish,or PERMIT 54 . 00 , 50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P/NON-RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 70W)of Division 3 of the Business PLAN
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(S500). ISSUE FEE
I, as owner of the progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
structure is not intended or uttered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 . 00 0. 00 54 . 50 54 , 50 ,, 6 . 00
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 employees,provided that such improvements are not intended or offered for sale. It.however the building or REVENUE DIVISION TOTALS--> COLLECTED• 54 . 50 OVER/SHORT; •;•
-,' 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve
for the purpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exctusivel9 contracting with licensed contractors to construct the project(Section 7044,Business 54 . 0 0 5 0 ..
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST OTAL COST
Date: Owner: SFR 25 FIRE DAMAGE / $100 RES NOZONE 100.00 n 2, 500. 00
I do hereby cenity that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a r
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant.
I hereby certify that I have read this application and state that the above information is correct.I agr to comply with all city and county
ordinances and per
ion relatingpposeto building construction and hereby a thorizerepresenlativ i this a the above-mentioned _
property a i .tat ionsrep ✓ toe O -'t.'1 1: . :1.. ;-: - r
r- Ta f ..
• , Date: Si nature: /i
Driver's L Ce• e or Social Security 4:
164146 White—Budding:Green—Code Enforcement:Canary—AoolicanC Pink—Revenue:Goldenrod—Assessor
r
CONSTRUCTION AND PLANNIN L & 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. I 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 _ • 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 .r 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-7 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 • 411.7...q- & 'f 73: Undergrnd.Storage Tank O Gas ❑Oil
25. Roof Sheathing L1l[1-j!,_ (LIZ 6c -k/r '74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat_/ ! _ N! 75. Dry Chemical .
27. Frame and Flashing 76. Dry Standpipe - -
28. Lathing& Siding' 77. FIXED SYSTEM FINAL
29. Insulation ,1 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 ' , 1. Notes:
'34. Final Heating & Air Conditioning •
35:•Final Gas Pipe-Test _ . 1 - -
36. Hood or Canopy . 1 '( .
37..Final Factory Fireplace - � ••i
38. Final Plumbing • '
39. Water Service-Final. '
•
,40. Gas Service-Final • C 1
41. Solar Domestic-Final . - •
n
42. Backflow Preventer -
43. Backflow Irrigation .
44. Landscape Irrigation System - -
45.'Sound Attenuation • - I .
46. Handicap Regulations `
4 i- L!/
47.-FINAL STRUCTURE & BUILDING /�!L l%re O _�pQ�Y///QJkc_ et
48. FINAL PLANNING Nee, �G�N� aJ��
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co I ij
51. CERTIFICATE OF OCCUPANCY
No. Date
I PROJECT ADDRESS: 276 E 20TH ST . UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05694 )
OWNER'sNAME: WHELAN PROPERTIES
( ADDRESs: 666 BAKER ST PERMIT NO: B 056947 PLAN CHECK NO: N GOVT: N SUPT: N
COSTA MESA
CA 92626 CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: REP
(714 ) 540-3666
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REPLACE FIRE DAMAGED RAFTERS 6 ROOF SQ FT: 800
. ADDRESS: UNIT:
CLAIM VALUE: 800. 00 CALL—VALUE: 800 , 00 GROUP OCC: R-3 /
PERMITTEE: JAMES R. THOMPSON CONST. ( 714 ) 636-2557
ADDRESS: 13592 FERNWOOD COMMENTS: FIRE DAMAGE CAUSED BY BBQ/REPAIR
GARDEN GROVE CA 92643 #********************************* ********************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my • full force SETBACKS
CDate:Y : 0401 __7 6 STATE/ Sign 8 re: s: AGi�� l �
Date: — 5 Signature: _ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby atfirm that ha ten tate of consent If-insur a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR ; FT IN
Compensation u{age.p�a,�en eQ4 pythereof(Section 3Bgo. ab. LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: 4G77L �"�7 EXP.DATE: 1 /O1 I93
yOMPANY: STATE PARKING REQ; PROV: PARCEL: 42621117 ZNE: REF NO:
'V Certified copy is hereby famished. ❑ Certified c• • is Med with - city Builds ''s' . PLANNING NOTES>
mate: S./s ,9,a_ Applica i hLA ***#*#******.#**#**#*##****#*****************#******#*********#******#*********#
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: 4--/.. need-it be completed P permit is for one hundred(5100)or less). D E V E. L O P M E N T S E R V I C E S R E Q U I R E M E N'•T S
I certify that in the performance of the work tor which this permit i issuedall not employ a person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: '�
. c
Date: Syoushul BUILDING APPROVED BY : DATE: i�
NOTICE:It.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor •
Code.you must forthwith comply with such provisions or VUs permit shall be deemed revoked. a--, -----".-''--�
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION vI SSUED B Y: —�S'• s -
DATE: O —/ c3 `?Z
which this permit is issued(Section 3097.Civ.C). ***********,}E!#�**•)E****** •.:s's'�•+•a Lw... •s...,— >rt. " " • "*********** *: aer.feXr.)e**
LENDER: ************Yt************* ******* *************************$***�k**********
ADDRESS: LEGALIZATION:N F E E UMMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors State License Law for the following reason BLDG PMT PLUMBING ELEC RIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 21 . 0 0 5.91'
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON ES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN f`.•
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 hor a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID / DUE
I. as owner of the property ar my employees with wages as their sole compensation, will do the work, and the TOTALS----> 21 . 50 0 . 00 0 . 00 21 . 50 21 . 50 . 00
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State 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 employees,provided that such improvements are not intended or offered for sale.IL however the building or REVENUE DIVISION TOTALS--> COLLECTED : 21 . 50 OVER/SHORT- — 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve
for the purpose ot sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 21 . 00 , 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ((�r
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Slate License Law).l am aware ***************************************###***************************1f*********
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: 8.8 P.C. _
tor thisreason: TYPE QTY DESCRIPTIO N UNIT COST • TOTAL COST
Date: Owner. SFR 800 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 800 . 00
I do hereby certify that I am aware of and understand the requirements 01 California Health and Safety Code Sections 25505.25533,and END OF FEES •
minim25534 and that 1 or any future building occupant minimnot(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from theraty Management District.Residential construction applications are exempt from
these provisions.
Date: _ Applicant: e.
•
I hereby certify that I have read this application and state that the abet information is•• ree to comply with all city and county
ordinances and state laws relating tobuilding construction an. ereptY city to enter upon the above•mentioned
properly for ins ection purposes. -
---_ Date: — Signal
Driver's License or SocMI security e. -
1641-46 White—Building:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor .
CONSTRUCTION AND PLANNING POOL PA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit #
1. Temporary Electrical Service& Pole 52. Pool & Equipment Location
i •
2. Soil Pipe-Undrgrnd.p p1 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
t./
4, Electrical Conduit-Undrgrnt#.1.' 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 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. I tb/
60. Backwash Lines, P•Trap, 0 Undrgrnd. / l� /
10. Structural Flo0r Syste 61. APPROVAL TO DECK
11. Property Sewer Line & Hou • - •nnection.
62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains II G- 64. Plumbing System - Final
14. Rough Plumbing „f7' 65. Electrical-Final 2
15. Rough Electrical-Conduit '• 66. Solar System-Final
16. Rough Electric Wiring -1 67. Fencing & Access Approval
17, Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOLJSPA 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 '�(YQ2 G'v/,L 73. Undergrnd.Storage Tank 0Gas 0Oil
25. Root Sheathing (��Jy_ &41jjt 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat t (Illi' 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 , I
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 C
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING l -q2 &c4. ,
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE OF OCCUPANCY
No'. Date
f JILDING AND SAFETY DIS tON •
FIRE DAMAGE INSPECTION REPORT7/i ;yc-. '-E 6-
(Required Prior To Permit Issuance) c - 7f=
•
2 7 C C. -t
Address: Ci - S Unit:
Owner: 7-7.r- {r „ U,/ir r. ( f r, eratttf4-
Owner's Address Of different from above):
Street City State
15 Structural permit required.
Repair or replace as necessary.
❑ Plans required.
f ) , {' � 7 Siff /
Comments: � C e '7! {' ,� r.-� -7
{ 5/ �-k , < „ F e-/yr,( ( is e /i 5-ore ,., c. -*
f.. ,- dCc_ )
•
gi Electrical permit required.
Eg Repair or replace as necessary.
Comments: r/3/n re L'' . r +�
I /
0 / /1 ir L. - /' TGIF /1-7( t-G- •
( r!r r7 a it s tic? oL )
❑ Plumbing permit required.
❑ Repair or replace as necessary.
Comments:
❑ Mechanical permit required.
❑ Repair or replace as necessary.
Comments:
/Air ' . //4://
3 -2 / / - 5-47)
Inspector Date Phone
1872-46 Triplicate:Original-Owner;Vellow-Contrator; Pink.Building Division
-
•
PROJECT ADDRESS: 276 E 20TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 056948
OWNER'S NAME: WHELAN PROPERTIES
ADDRESS: 666 BAKER ST PERMIT NO; E 056948 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA
CA 92626 CONSTRUCTION TYPE: 5-N PERMIT TYPE: ELE PURPOSE; REP
(714 ) 540-3666
ARCH/ENGINEER: ,REG.ND.: JOB DESCRIPTION : REPLACE FIRE DAMAGED RAFTERS & ROOF SQ FT:
ADDRESS: UNIT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
PERMITTEE: JAMES R. THOMPSON CONST. ( 714 ) 636-2557
ADDRESS: 13592 FERNWOOD COMMENTS; FIRE DAMAGE CAUSED BY BBQ/REPAIRp\51,-41.47J
GARDEN GROVE CA 92643 ***********�H+E*+ETH*kFx*N�H�E�Ft�**x• *�E* *F *�E�E�6�6�H *** ** ***************> ******* *RH*>
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my li in lull far b L SE TB ACK S
CITY uc.: 0 0746 STATEuc,:34894 ss:
MAIN BUILDING ACCESSORY BUILDING
Coate Signatu - FRNT: FT IN REAR; FT IN FRNT; FT IN REAR ; FT IN
WORKERS'COMPENSATION DECLARATION: I hereby a amt ave ertificate o consen self- sure or a certificate of Workers' LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
Compensation Iptssu5ago.Aj cerWeT^y thereof(Sectio 3800,
POLICY NO.: —+� "� EXP.DA E: I /U 1. /9 3
yyyOMPANY: STATE PARKING REQ: PROV; PARCEL: 42621117 ZNE; REF NO;
J Certified copy is /�hereby furnished. C Certified C,• s filed wit he city B 'iv''<. PLANNING N TES>
4-44-4 Date: �J ! 2 Applic. t'. , - r . *********************************if. '1f*IF*****************-1E***********************
DEVELOPMENT S E'R V I C E S REQUIREMENTS
EKEMPTIO FROM WORKERS'COMPENSATION DECLARATION: (T`.'tctian n••r not be completed Ter it is for one hundred(5100)or less). -
I certify that in the performance of the work for which this per t'•issue',I shall not employ.ny person in any manner do as to become •0.i
I subject to the Workers'Compensation Laws of California. ZONING APPROVED BY ; DATE
Date: Signature: BUILDING APPROVED BY DATE:
NOTICE:II.after making this declaration.you should become subject to the Workers'Compensation provisions of,the Labor
-
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. '7_ C— —��11
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: �.: -- �� DATE: C 510-/,3 72.-
which this permit is issued(Section 3097.Civ.C). ,f, ********************** . ' - ****************3eie****
LENDER: ***********************************5R6* b****************************************
ADDRESS: LEGALIZATION:N F E E . SUMMARY STRUCTURAL SEGMENT:N
•
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELEC 'RIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 75
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0% SM I P/NON-RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 15 . 00
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
❑ sas owner of the property or my employees with wages as their sole compensation, will do the work, and the
—tructure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS-- —> 0. 75 1 S , 0 0 0 . 00 1r, 75 15. 75 . 00
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 employees,provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 15 , 75 OVER/SHORT: 00
improvement is said within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
for the purpose at sale).
15 . 75
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business
❑ and Professions Code: The ch projects Contractors'State License Law does notapply rsuanto anownere property who builds or improves thereon *******************************************************************************
and who contracts for such projects with a e License
pursuant to the Contractors'State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: ELE 1 FIXTURES, LIGHTING 1 ST 20 EA. 75 . 75
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date'. Applicant:
I hereby certify that I have read this application and state that I ' -•• •information is correct I ear- comply with all city and county
ordinances and state laws relating to building construction... ereby aut .rize representatives of thi
to enter upon the above-mentioned
property f f inspection purposes_
! Dale'��--1 ioc2 Signature. _ /f .A._. _i
3Q11f'Iii.2,:iii _. _
DATE: 04/13ja2 T7c
(,•.'
Driver's License or Social Security H_ /
1641-46 White—Building,Green—Code Enforcement;Canary—Applicant:Pink—Revenue,Goldenrod—Assessor
\'
CONSTRUCTION AND PLANNING POO. ,PA
APPROVALS Permit, Date Inspector APPROVALS Permit # Date InspeGt-or
/', ,
1. Temporary Electrical ServigeiS1t Pole .' 52. Pool & Equipment Location 1
2. Soil Pipe-Undrgrnd. - -../ J - 53. Steel Reinforcement
,.lo rJ
3. Electrical Conduit Utility-Undrgrnd. ' 54. FormsOl
5" n
4. Electrical Conduit-Undrgrnd.,r, q 55. Electrical Bonding '?
5. Steel Reinforcement ^ 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE
i
7. Footings „en „---,
, 1 58. Electrical Conduit-Undrgrnd.
8. Foundation / // 7 ../e 59. Gas Pipe, 0 Undrgrnd., Test i 77)/: \
9. Water Pipe-Undrgrnd. /f ( /�3� 60. Backwash Lines, P-Trap, 0 Undrgrnd. 11/ ,4 'l
10. Structural Floor System `/ 61. APPROVAL TO DECK //
11. Property Sewer Line & Ho neonnection.r' h' 62. Backwash & Receptor-Final /0.i '
•
12. Sewer Cap ( ,j - •
63. Heater & Vent-Final
13. Roof Drains c7 Gv 9' 64. Plumbing System - Final j flat 1
14. RoughPlumbing �' - y
'/ 65. Electrical-Final
15. Rough Electrical-Conduit \ t ) -/ c- , Solar System-Final ,
16, Rough Electric Wiring 11 0j/�1 _re- • Fencing & Access Approval
17. Rough Wiring Sign v��/�7 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling I 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 ❑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 Flashing76. 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 _ I 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric c3j ,ZteeQ Notes:
34. Final Heating & Air Conditioning Tx.
35. Final Gas Pipe-Test I /" -
36. Hood or Canopy (,
37. Final Factory Fireplace
38. Final Plumbing •'
39. Water Service-Final
40. Gas Service-Final I)
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. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date