HomeMy WebLinkAbout336 20TH ST - Building Permits,-,
(714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
,lob Address: 336 E 20TH ST
Suite: 1
Vicinity: UNITS 1 AND 2(DUPLEX)
Parcel Number: 42622139
Zoning:
Applicant: NARBUTAS, KES
Address: 220 SANSOME , �
7TH FLOOR - . Phone: 415-722-2600
SAN FRANGSCO; CA . � Zip: 94104
Owner: PORTICO PROPERTIES-NEWPORT HEIGHTS, LLC
Address 220 SANSOME
7TH FLOOR Phone: 415-722-2600
SAN FRANCISCO, CA Zip: 94104
Contractor
Address:
Zip:
Arch :
Address:
Phone:
License:
Eng:
Address:
Phone:
ISSUED BY:
Status: ISSUED
Applied: 01 /16/2002
Issued: 01/16I2002
Phone:
Zip: License: License:
SCOPE OF PERMIT
REPLACE WINDOWS IN LIVING ROOM AND REPLACE SIDING�AT FRONT OF UNIT(S). DUPLEX UNITS 1 AND 2.
PEE SUMMARY
Plan Check: $0.00
Permit: $29.60
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $30.10
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: 0
NOTES:
Rear 0-0
Rear 0- 0
Required: 0
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation: S�oo.00
Claim Valuation: $�oo.00
Right 0- 0
Right 0- 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
'�� EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectiona and final epproval must be obtained. Failure to obtain inspections and final approval will resutt in the expiration of ihis pertnit.
FOR INSPECTIONS CALL: (714) 7545626
?446�48(B/oo)
WORKERS'COMPENSAnON DECLARAnON: -
I hareby aflirm untler penelty of perjury one ot t�e following declarations: � .
❑ I heve end will.maintein e certiticate of wn5ent to 5elf-Insure for workers' compen5ation, es provitletl tor by 50ction 3700 ot Ihe Lebor Code, tor Iha pertormance of Ihe
work for which this pertnit is issuBd. .
❑ 1 have antl will mainiain workere' compensation insurance, as required by section 3700 of the Lebor Cotle, for Ihe perfortnance of t�e work for which this pertnit is issuetl.
My workers' compensatlon Insurance cerner antl policy number era: �
Carrier. Poliry Number.
(This secNon neetl not be completed i! fhe permi( is velued et one hundred dollars ($f00) or less.)
❑ 1 cenity Mat in the peAortnanca of the work for which this pertnit is issueQ I shall not employ eny person in eny manner so es to become SUD�ec� to the workers'
compensation lews ol Calitomia, end agree that il l should becoma subject to the workers' compensation provisions of Sactlon 3700 of Ihe Labor Cotle, I shall forthwit�
comply with these provisions.
Applican� Signa�ure: Date:
WAqNINO: FAILURE TO SECURE WORKERS' CO`APENSATION COVERAGE IS UNLAWFUL ANO SMALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES ANO GVIL FINES UP TOONE HUNDRED
TFIWSAND DOLLARE (5100,000), IN A�DRION TO iHE COST OF COMPENSATIpV, DAMAGES AS PPOVIOED WR IN SECTIQV 3�08 OF THE LABOR CODE, INiEPEST, AND AiTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION: �,
I �ereby eNirm t�at I am Ilcensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business en0 Professions Code, antl my license Is in full �i
force end efleC�. Lia M Cless p
Contractofs Signature: Oate:
CONSTRUCTION LENDING AGENCV:
❑ I �ereby eHirtn that there is a construction lending a9enry for the peAormance of the work lor which ihis permit is issuetl. (Sec. 3097, Civil Cotle).
Lentlefs Neme: Lentler's ACdress:
SignaNra: � Data:
OWNER-BUILDER OECLARATIONS:
I hereby aHirm that untler penalry oi perjury that I em EXEMPT FROM THE CON7RAC70RS LICENSE LAW br ihe following reason (Sec. 7031.5, Business and Professions
Code: Any city or county whicn requires e pertnit to construct, alter, impmve, demolish, or repair eny structure, pnor to its iuuance, elso requires the applicant for such pertnit
to file a signetl statement that he or she Is licensed pursuant to the provisions of the Comractors License Lew (Chapter 9(commencing with SecNon 7000) oi Division 3 ot Ihe
Business entl Protessions Code) or t�at he or she is exempt therefmm and the basis for the allegetl exemption. Any violatian of Section 7031.5 by any applicent for a permit
subjects Ihe epplicant to a civil penalry of not more than tive huntlred dollars ($S00).): �
❑ I, as owner of the property, or my empbyees with wages as �heir sole compensation, WILL DO 7HE WORK, end the strucWre is not iniendetl or oflered for sale (Sec.
7044, Business and Professions Cotle: The Contractors License Law dces not apply to an owner of properry who builds or improves ihereon, and who does such work
himsell or herseH or Ihrough his or her own employees, provided ihat such improvemenis are not intendetl or oflered for sale. If, however, ihe building or improvement is
sold within one year ol complation, the owneo-builtlar will have ihe 6urden of proving that he or she ditl not builtl or improve for purpase oi sele.).
❑ I, as owner of Ihe property, am E%CLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Catle: The contrectars License Lew Aoes no� eppy to an owner of property who builds or Improves t�ereon, entl who conirects for such prolect with a contractor(s)
license pursuant to the Comractors License Laws.).
❑ I am ezempt untler sec.
Signature:
Owner ID venfied by drivefs licensa. ❑ Ves ❑ No
Business and Profeuions Code tor Ihis reason:
Venfication of Ownership by (type of tlwument, i.e. - proparty taz 6ill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
Driver5 LiCense No.
oate:
E�ires:
❑ I hereby catlify that no excavation five (5) or more feet in depth into which a person is requiretl to descenq will be mede In connection with wodc authorized by Ihis
permit, and that no building sWcture, scaHolding, felsework, or aemolition or tlismantling thereol, will be more than thirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, lltle B, Celllornla Adminisirative Coda).
❑ As owner-builder, I will not employ enyone to do work which would require n permit irom the Division of Intlustrial Safety, as noted ebava, unless such person hes e
permit to do such work Irom the division.
Signature: Oate:
Division ot Indusirial Salety Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF EMAY: I certiy under penalry ol perjury that 1 hava reed Ihis application end state ihat Ihe intortnation given is
wrrect. I egree to comply with all s;ete lews end ciry ortlinances relating to building consiructlon, and au��onze representa�ives of the Ciry of Costa Mesa to enter upon the
ebove-describetl properry for inspection puryoses. I agree not to occupy or aliow wcupency of any building authonzed by Ihis permit until final inspection.
Signature Oi Legal Owner(s) Date
AndiOr Authorized Applicant
40DE �. INSVECTIONTYPE
1616 Fixetl System Final Fire Prevention
7266 Pool Spa Final
200 Final Re-Rool
201 Finel BIxWRetaining Wall
202 Final Fectory Fira Place
203 Finel Sign
204 Final Demalition ..
COOE I INSYECTION TYPE
206 Final Mechanicel
208 Final Plumbing
210 Final EleCtrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/OccuDency
PdIE Il�Lfl
(-z�-�z ��-
1
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
,lob nddress: 336 E 20TH ST
Suite'. 5
Vicinity: UNIT 5
Parcel Number: 42622139
2oning:
Appliwnt: NARBUTAS, KES
Address: 220 SANSOME -
7TH FLOOR , Phone: 415-722-2600
SAN FRANGISCO, CA ' Zip: 94104
Owner: PORTICO PROPERTIES-NEWPORT HEIGHTS, LLC
Address 220 SANSOME
7TH FLOOR Phone: 415-722-2600
SAN FRANCISCO, CA Zip: 94104
Contractor:
Address:
Zip:
Arch :
Address:
Phone:
License:
_ Eng:
Address:
Pho�e.
ISSUED BY:
Status: ISSUED
Applied: Otl16(2�02
Issued: 01/76/2002
Phone:
Zip: License: License:
SCOPE OF PERMIT
REPLACE WINDOWS IN LIVING ROOM AND REPLACE SIDING AT FRONi' OF UNIT(S). UNIT 5.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$29.60
$0.50
$0.00
$0.00
$0.00
$30.10
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Ezistinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
s�oo.00
s�oo.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calilomia statutes arM related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced withln 180 days, or If work is suspended or abandoned
for a p�riod ot 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all
requlrad Inspectiona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
266&68 (�)
WORKERS'COMPENSA710N DECLARATON: . -
I herehy ettirtn under penalry ol perjury one of the followinq dedarations: - �
❑ I hava end wlll maintein a certificate of consent to sell-Insure for workers' compensation, as O�ovided for by section 3700 of the Labor Code, tor the peAortnance of the
work for which ihis permit is issued.
❑ I have end will maintain workers' compensation insurance, as required by section 3700 of lhe Labo!�ode, � r the pedortnflnce of tha work br which Ihis pertnil is iuued.
My workers' compens/a�tio'n rInsnuranca carn antl policy numDer ere: �
Carrier. ��\!/V�Y/��� PolicyNumber:
(Thls sec ' n neetl no! be �mp/efed il [he p rmif Is valuetl et one huntlred dallers ($100) or /essJ
1 certity fhat in Me p9 rmanca of e ork for w'ch this p i� is issuetl, I shalf nol employ any person in any manner so as to become subjecl to lhe workers'
compensation laws 0 litomia, a' a that i s�ould ome sublect to Ihe workers' compensation provisions of Sealon 37Q0 oi the Labor Cotle, I she0 forthwit�
comply with these pr i s I/ O^��
'ApplicanPSigna : Date: I I CD I /l
WARNINO: FAILURE TO SEC E WORKERS' COMPENSATION WVERAGE IS UNLAWFUL AND SHALlSUBJECT AN EMPLOVER TO CRIMINAL PENAL ES AND CIVIL FINES UP TOONE HUNDPED
THOUSANDDOLIARE(5100. ),INADDfTIONTOTHEWSTOFCOMPENSATIIXJ,OAMAGESASPROVIDEDFORINSECTIIXJ3]O60FTHELABORCODE,IMEPEST,ANDAiTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I here6y ettirm that I am licensed untler provisions ol Chapter 9(commencing with Section 7000) of Division 3 of the 8usiness antl Professions Cotle, antl my license Is in full
force entl eHec�. LJc. k Cless»
Cantractors SlgnaWre: Date:
CONSTRUCTION LENDIryG AGENCV:
❑ I hereby aHirm Ihet there is a construction lending agenty for t�e pertortnence ol iha work for which ihis permit is issuetl. (Sec. 3097, Civil Cotle).
Lendefs Name: Lendets Address:
Signature: � Date:
OWNER-BUILDER DECLpqp7�ONS:
I hereby ettirtn that under penalry of perjury thet I am E%EMP7 FROM 7ME CONTRACTORS LICENSE LAW tor I�e following reason (Sec. 7031.5, Business end Professlons
Code: Any city or county Whic� requires a permit to construct, alter, improve, demolish, or repair any sWcture, prior ro its issuance, also requires ihe ap0liwN for such permit
to file e signed stetement Ihat he or she is IicenseC pursuant to the provisions of lhe Contrectors License Law (Chepter 9(commencing with Section 7000) oi Division 3 of the
Business antl Prolessions Code) or that �e or she is exempt Iherefrom antl the besis for the alleqed exemption. Any vioiation of Section 7037.5 by any applicent For a permlt
subjects Ihe epP�icant to a civil penalry of not more than five hundred dollars ($500).):
❑ I, es owner ot the prOperty, or my empbyees with weges as their sole crompensatioq WILL DO THE WORK, erid Ne stmcture Is not interMed or ottered for sale (Sec.
7044, Business end Professions Cotle: The Contrac�ors License Law does not apply to an owner of propeny who builds or improves thereon, antl who does such work
himselt or herseli or through his or her own employees, provided that such improvements are not intended or oHered for sale. If, however, Ihe buil0ing or improvement is
soltl within one year of compietion, the owner-builder wiil have the burden of proving ihat ha or she tlitl not build or improve for purpose oi sale.).
❑ I, as owner ol ihe prOperty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constr�ct the projact (Sec. 7044, Business antl Professions
Code: The contrectors License Law tloes not appty to an owner oi property who builds or impmves thereoq antl who coniracts for such project with a contractor(s)
licanse pursuant to the Contrectors License Laws.).
❑ I am erempt under sec. Business and Pmfessions Coda for this reason:
SignaNre: Dete:
Owner ID vetitietl by dnveYS liCense. ❑ Yes ❑ No Dnvers License No.
Ventication oi Ownership by (type oi tlocument, i.e. - properry tex bill or tleatl):
Expires:
DIYISION OF INDUSTAIAL SAFETY PERMlT CEATFICA710N:
❑ I hereby certify ihat qo eacavallon five (5) or more feet in tlepth into which a person is required to descend, will be matle in connection with work euthodzetl by this
permit, end that no huiltling siructure, scafloltling, falsework, or demolition or tlismantling Ihereof, will be more ihan thirty-six (36) feat high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Calitomia Adminis�rative Cotle).
❑ As awner-builder, I Will not employ enyone to tlo work which would require a permil irom ihe Division of Indusiriel Safery, es noted ebove, unless such person hes a
permit lo do such wqrk from the division.
Signeture: Date:
Division of Indushial Setety permit Number.
CERiiFlCA7E OF COMPlIANCE AND AUTHORPATON OF EMRY: I cartity under penalry of perjury that 1 have iead this application arW slate that Ihe inlormation g'iven is
wrrect I agree to comply with all state lews and ciry ordinences releting to building consimction, end authonze representatives ot the Ciry ol Cosla Mesa to enter upon ihe
above-tlescribed pmperty br inspection purposes. I egree�ot to occupy or allow occupency of eny building euthorized by this permit until tinal inspection.
COUE L MSPECTIONTYPE
1616 Fixed System Finel Fire Prevention
1266 Pool Spe Finel
200 Finel Ae-Roof
207 Pinal BIwWRetalning Well
202 Final Factory Fire Place
203
204
Final Sign
Fina6Demolition
:ni�
� �(��o�
Date
j[Q�J�¢ QQp� INSPECTIONTYVE
206 Finel Mechenical
208 Final Plumbing
210 FinalElectricel
212 Final Flre Prevemian
220 Finai Plenning Approval
222 Finel Site
250 Finel Builtling/Occupency
Qdg It�ELS
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
.lob Address: 336 E 20TH ST
Suite: 7
Vicinity: UNITS 7 AND 8 DUPLEX
Parcel Number: 42622139
Zoning:
Applicant: NARBUTAS, KES
Address: 220 SANSOME
7TH FLOOR Phone: 415-722-2600
SAN FRANCISCO, CA ' Zip: 94104
Owner: PORTICO PROPERTIES-NEWPORT HEIGHTS, LLC
Address 220 SANSOME
7TH FLOOR . Phone: 415-722-2600
SAN FRANCISCO, CA Zip: 94104
Contrac[or.
Address:
Zip:
Arch :
Address:
Phone:
License:
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 0 V 16/2002
Issued: 01 /16/2002
Phone: Phone: �
Zip: License: - License:
SCOPE OF PERMIT
REPLACE WINDOWS IN LIVING ROOM AND REPLACE SIDING AT FRONT OF UNIT(S). DUPLEX UNITS 7 AND 8.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$29.60
$0.50
$0.00
$0.00
$0.00
$30.10
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING 8 ZONING
Left 0- 0
Left 0- 0
Ptoposed: 0
Calc Valuation:
Claim Valuation:
Right 0- 0
Right 0- 0
s�oo.00
s�oo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If vrork is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authonzed under this permit to be considered legal, such work must comply with all applicabie codes, and ell
requlred Inspectlons and final epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545826
zaawe �erao�
WORKERS'COMPENSAnON DECLAqAnON: - �
I heretiy aHirm under penalry of perjury one of the following declarations:
❑ I have antl will maintain e certilicate ol consent to self-Insure for workers' compensa�ion, es provitled for by section 3700 of the Lebor Coae, tor the peAortnance ot the
work tor which Ihis permit is issuetl. �
❑ 1 have and wiil maintain workere' compensation insurance, as required by section 3700 of Ihe Labor Cotle, tor Ihe pedortnance ol lhe work lor whlch ihis pertnit is issued.
My workers' compensatiop Insyrance wrtieyapc)bo�q number are: •
Carrier.
Policy Number:
nis s tion neetl nat be campleted il Nle pennif i.� velued a( one hunOred dollers (5100) or Iess.J
I certify that in the pertor nce of the Wo c tor which this per it is issueQ I shall not employ eny person in any menner so as to become subiect to the workers'
compensatlon laws of Ce i ia, and $ re that If I s ould b ome sub�aq m the workers' compensation provisions oi Sectiona 700 of t�e Labor Cotle, I shell lorthwith
wmplywith these provisi , A I/'' ^/ U�
.—�—
Applicanl'S(gnemre:. •Y Date: � �Y
WARNING: FAIWRE TO SECUFE WORKERS' WMPENSAiION COVERAGE IS UNLAWFUL AND SMALL $UBJECT AN EMPLOYER TO CRIMINN. P NALTIES qVIL FlNES UP TO ONE HUNDPED
THOUSaND DOLLARE ($100,000), IN AODRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR WDE, IMEREST, AND ATTORNEY'S FEES.
IICENSED CONTRACTORS DECLARATION:
I hereby attirtn that I am licensetl untler pmvisions ol Chapter 9(commencing wit� Section 7000) ot Didsion 3 0l Ihe Business and Professions Code, and my license is in full
force entl aMec�. Lic. a Cless a
Contractors Si9nature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby effirtn ihat there is a consiruction lending agency br ihe pedormance of I�e work lor which this pertnit is issued. (Sec. 3097, Civil Code).
Lendafs Name: Lenders Atldress:
Signature: � Date:
OWNER-BUILDER DECLARATIONS:
I hereby aRirtn ihat under penalry of perjury thet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, 8uslneu entl Professlons
Cotle: Any ciry or counry which repuires a pertnit to consWct, alter, improve, demolish, or repair eny strucWre, D�or to its issuance, elso requires ihe epplicant for such pertnit
to file a signetl stetement ihet he or she is licensed pursuant to Ihe provisions ot ihe Comractors Licensa Lew (Chapter 9(commendng with Section 7000) ol Division 3 at the
Business and Professions Code) or that he or she Is exemp� Iherefrom and the basis for t�e alleged exemption. Any violation of Section 7031.5 6y eny epplicant for e permit
subjects lhe applicant to a civil penalry of not more then tive hundred dollars (5500).):
❑ I, es owner of the pro0erty, or my employees with weges as their sole compensalion, WILL DO THE WORK, and the structure I5 not intanded or oHeretl fo� sale (Sec.
7044, Business and Protessions Code: The Contractors License Law dces not apply to an owner of property who builds or improves ihereon, end who tloes such work
himsetl or hersell or through his or her own employees, proviaatl that such impmvemanis are not intende0 or oflered br sele. 11, however, Ihe building or improvement is
soltl within one year of complelion, tha owner-builder will have the hurden of proving that ha or she did nol build or improve for purpose ol sale.).
❑ I, es owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business entl Professions
Code: The contrectors License Lew tloes not eppy to an owner ol property w�o builAs or Improves thereon, entl who contrects lor such project with a conirector(s)
license Dursuant to iha Conlractors License Lews.).
❑ I em exempt under sec.
Si9nature:
Owner ID verifietl by drivers licen5e. ❑ Yes ❑ No
Busineu and Professions Code tor this reason:
Venfication of Ownershlp by (rype of tlocumeni, i.e. - property taz bill or Aeetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N:
Driver5 LiCenSe No.
Date:
Expires:
❑ I hereby cenify that no excavation tive (5) or more feet In depih into which a person Is required to descend, will be meda In connectlon with work euthorized by this
pertni�, end that no 6uiltling strucwre, scaHoltling, falsework, or demolition or dismamling thereoi, will be more Ihen thirty�siz (36) feet high. (Chap. 3.2, Gry 2, A� 2, Sec.
341, Tiile 8, Celifomia Adminisiretive Code).
❑ As owneo-builder, I will not employ anyone to do work which woultl require e perml� from the Division of Intlustriel Satery, es noted above, unless such persan hes e
pertnil Io do such work from ihe tlivision.
Signature: Date:
Division of Intlustrial Safery Pertnit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF EMRV: I cenity unde� penelty ot perjury ihat I have read ihis epplication and stete thet the inlortnation given is
correcL I agree to compry with all sate laws end ciry ordinences relating to Duiltling construction, an0 euthonze representatives of the Ciry ol Caste Mese to enter upon the
above-descnbed p�openy for inspection purposes. I egree not to occupy or ellow acupancy of eny building authorized by this permit until final inspecGon.
CODE �, INSPEC110NTVFE
1616 Fixea System Final Fire Preven�ion
12fi6 Pool Spa Finel
� 200 Final Re-Rool
� 207 Fina181ocWRetaining Wall
202 Final Fectory Fire Place
203 Final Sign
204 . Final Demolition .
�E
�
1 Date
/ (o / b 'o�,-
oaie
IMRIALS 4Qpf,� INSPECTIONTYGE
206 Final Mechenical
208 Final Plumbing
210 Final Electrical
212 Final Fire Preventlon
220 Flnal Planning Approval
222 Finel Site
.250., Finel Building/Occupency
�
�
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
.lob Address: 336 E 20TH ST
Suite: 11
Vicinity: UNIT 11 - DETACHED BUNGALOW
ParcelNumber 42622139
Applicant: BUTCHER, CRAIG
Address:
Owner: MOORE, JOHN T
Address 1712 PORT MARGATE
NEWPORTBEACH,CA
Contractor: GOLD MEDAL
Address: 1683 N WINSTON WAY
UPLAND, CA
Zip: 91784
Aroh :
Address:
Zoning:
Phone: 909-949-2292
Zip:
Phone:
Zip: 92660
Phone: 909-949-2292
License: 798523
Eng:
Address:
Status: ISSUED
Applied: 09/20/2001
Issued: 09/20/2001
ISSUED BY: '
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REMOVE AND REPLACE FACIA, REMOVE EXISITING ROOF, REPAIR DRYROT AS NECESSARY AND APPLY 25 YEAR COMP
SHINGLE ROOFING.
Plan Check: $0.00
Permit: $97.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Reouired: 0
FEE SUMMARY
PLANNING 8 ZONING
Left 0- 0
Lefl 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Ri9ht 0-0
$3,325.00
83,325.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
, regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become vold it work is not commenced wlthin 180 days, or if work is suspended or abandoned
for a period ot 180 days.
INSPEC710NS: In order for ihe work authorizad under this permit to be considered legal, such work must compty with all applicable codes, and all
requlred Inepeetions end tinal approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
��� ���
WORKERS'COMPENSAnON DECLARATON: � i
I hereby eftirtn untler penalry of perjury one ol the tollowing Oeclerations:
❑ I heve end will maintein a ceNNwte ot consent to seli-Insure for workers' compensetion, es provided for by section 3700 ot ihe Lebar Cotle, for the peAormence of ihe
work for w�ich �hi5 permil 15 issuetl. .
❑ I �ave end wlll melntaln workers' compensellon insurance, as requiretl by sectlon 3700 oi the Lebor Code, for ihe peAortnance of t�e work for which ihis pertnit Is issued.
My workers' wm e on Insur e rrler and pollcy number ere:
R.'WPK - -. 9i' � ,
Cartier:
Pdicy Num6er.
� I certity Ihet In �he peAortnence ot Ihe work for which this pertnit is issuetl, I shall not employ any pereon in any manner so as to �ecome subject to t�e workers'
compensatlon laws of Celitomie, entl egrea that II I should become sub�ect to the workers' compansation proNsions of Sectlo�37� pe La'r Code, I shell torthwlth
comply wit� t�ese provisions. �� / T
Applicant Sigpetur � Date: I U
WARNING FAILURE TO SECURE WORKERS' C/�!W SATION COVERAGE IS UMAWFUL AND SW1LL SUBIECT AN EMPI.OYER TO CRIMINAL PEWILTIES M!0 CML FlNES UP TOONE HUNDRED
hId15AND DOLLARE (S10U,000), IN ADOfilavfOTHE COST OF COMPENSATION, DAM4GES AS PFWIDED WR IN SEGTdJ 3%OB OF THE LABOR COOE, IMEREST, PND ATTORNEI"5 FEES.
LICENSED CONTRACTORS DECLARATION:
, I hareby attirtn Ihat I em licensed under provisions ot Chepter 9(commencing with Section 7000) oi Division 3 of the Business and Professions Code, antl my Ilcense Is In tull
brce end efleC�. LIt. M Clau N
Contrectors Slgnet ��� �� - Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirtn thet there is a consiructlon lending agency for the pertormence ot the work for which ihis permit is issued. (Sec. 3097, Civil Cotle).
Lentler'S Neme: Lender's Atldress:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aflirm ihat under penalry ol pehury Ihet 1 em E%EMP7 FROM 7ME CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business entl Professions
Cotle: Any ciry or county which requires e permit to constmct, eller, improve, tlemolish, or repair any stmctura, prior to its issuance, also requlres the aDPlicant for such pertnit
to ille e signed stetement ihat he or she Is Ilcensed purauent to Ihe provisions ot ihe Contrectors License Law (Chepter 9(commencing wlth Sectlon 7000) of Dlvision 3 oi Ihe
Business entl Professlons Code) or thet �e or she is ezempt therefrom end the 6esis tor the alleged exemption. Any vloletlon ot Sectlon 7031.5 by any epplicent for a pertN'
subleds ihe applicent to a civil penelry af not mare than live huntlred tlollars ($500).):
❑ I, as owner oi �he properry. or my employees with wages es their sole compensation, WILL DO THE WORK, entl tha struc�ure Is not Intentletl or oHered lar sale (Sec.
7044, Business and Protessions Cotle: The Contrecrore License Law tloes not apply Io an owner ot property who Duiltls or improves Ihereon, entl who does such work
himself or hersetl or through his or her own employees, providetl thet such improvements ere not Intended or oHerea for sele. If, however, tha builtling o� Impmvement Is
soltl within one yeer ot completion, the owner-builder will heve the burden of proving ihat he or she did not build or improve for Ourpose ot sele.).
❑ I, as owner af the properry, em E%CLUSIVELV CONTRACTNG WITH LICENSED CON7RAC70R5 to consiruct the project (Sec. 7044, Business end Professions
Code: The contractors License Lew tloes no� epply �o en owner oi property who huilds or improves thereon, entl who coniracts lor such project with e contrector(5)
license pursuent to ihe Contrectars License Lews.).
❑ I am ezempt untler sec.
Signature:
Owner ID verifletl Dy tlnveYs license. ❑ Ves ❑ No
Business and Professions Cotle tor this reason:
Venfication ot Ownership by (rype ot tlocument, i.e. - propeny lex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
Drivefs License No.
Date:
Expires:
❑ 1 hereby certify �het no exwvetlon five (5) or more teet in depth into which e person is requiretl to tlescend, will be made in connectlon wi�h work authoAzetl Dy ihis
permi�, and Ihai no building structure, scaftolding, telsework, or demolition or dismantling theraof, will be more than thlrry-six (36) leet �iph. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Calilornie Administrative Code).
❑ As owner-builder, I will not employ enyone to do work which would require e Dermit from the Division ot Industnel Sefery, es noted above, unleu such pereon hes a
pertnit to tlo such work irom the dlvision.
Signature: Date:
DlNsion oi Intlustnal Sefery Pertnit Number:
CER7IFlCATE OF COMPLIANCE AND AUfHORVA710N OF ENTRY: I cartity under penalry of perjury that I heve read this epplication end stete thef the intortnetion given is
correct. I egree to comply with ell stete laws and ciry ordinances relating to 6uilding consiruction, and authodze reDresentatives of the qry of Costa Mese to enter upon ihe
eDove-described properry for inspection puryoses. 1 egree not to occupy or allow occupancy of any huilding authorized by this pertnit until final inspection.
CODE t. INSVECTIOHTYFE Qd¢, �{,5
1616 Fixetl System Final Fire Prevention
1266
200
201
202
203
Pool Spe Finel
Finel Re-Rooi
Finel BIxWReteining Well
Final Fectory Fire Place
Finel Sign
204 Final Demolitlon
2� �'%
Date
COOE� INSPECTIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Finel Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 FinalSite
250 FinalBuiltlingiOccupancy
� I��
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626
BUILDING PERMIT
.lob Address: 336 E 20TH ST
Suite: 6
Vicinity: UNIT 6- DETACHED BUNGALOW UNIT
Parcel Number: 42622139
Applicant BUTCHER, CRAIG
Address:
Owner: MOORE, JOHN T
Address 1712 PORT MARGATE
NEWPORTBEACH,CA
Contractor: GOLD MEDAL
Address: 1683 N WINSTON WAY
UPLAND,CA
Zip: 91784
Arch :
Address:
Status: ISSUED
Applied: 09/20/2001
Issued: 09/20/2001
Zoning:
ISSUED BY: �
Phone: 909-949-2292
Zip:
Phone:
Zip: 92660
Phone: 909-949-2292
License: 798523
Eng:
Address:
Phone:
Phone:
Zip: License: License:
SCOPE OF PERMIT
REMOVE AND REPLACE FACIA, REMOVE EXISITING ROOF, REPAIR DRYROT AS NECESSARY AND APPLY 25 YEAR COMP �
SHINGLE ROOFING. - �
Plan Check: $0.00
Permit: $97.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Lek 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Righl 0- 0
Right 0-0
$3,325.00
$3,325.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access �equirements under Cali(ornia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
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 Inspectlona and flnal approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOfl INSPECTIONS CALL: (714) 754-5626
id46-08 (8�00)
WORKERS' COMPENSATION DECLARATION:
I hereby ettirm undar penalty of perlury one of iha following declarations:
❑ I heve and will maintain a certl0cete of consent to seli-Insure for workers' compensetion, es providetl for by section 3700 of iha Labor Code, for the peAormance of the
work for which �his pertnii is Issuetl.
❑ I have and will maintain workers' compensation insurance, as requlred by section 3700 oi Ihe Lebor Code, for the peAortnance of ihe work for which this pertnit is issued.
My workers' comperjsetian Insurence carAer end palicy number ere:
Carrier, r' • Policy Num�er.
is section need nat be campleted /l (he perm/f is ve/ued et one hundred dollers ($100) or less.J
I certiy ihat in the peAortnance of Ihe work for which this permit is issuetl, I shall not employ eny person in any manner so as to become subject to the workers'
compensation laws of Calitomia, entl agrea that if I should become su6ject to the workers' compensatlon provisions oi Section 3700 of the Labor Code, I shell forthwith
comply with these provisions. � I�/ � I
Applicant Sigr ur Dete:
WARNING FAILURE TO SECURE WORKERS' ATIIXJ COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLURE (E100,000), IN AD�O THE COST OF COMPENSATION, DANAGES AS PROVIDED FOR W SECTION 3)Ofi OF THE LABOR CADE, IMEREST, AND FTTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirm Ihat I em licensed under provislons ot Chapter 9(commencing with Section 7000) of Dlvislon 3 ot the Business and Pmfessions Code, and my license Is In tull
force entl eNect. Lic. N Class #
ConirectoYs SiqnaLue. � Date:
^ T-
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn that there is a construction lending agency for the perlormance oi ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
SigneNre:
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aftirtn that under penalry of perjury that I am EXEMPT FROM TliE CONTFiACTORS LICENSE LAW lor tha following reason (Sec. 7031.5, Business anG Protessions
Cotle: Any ciry or county which requires e permil to construct, elter, improve, demolish, or repair eny structure, Orior to its issuance, also requires the applicant for such pertnit
to file e signed stetement �het he or she Is Iicensetl pursuent to ihe provislons of ihe Gontractors Licanse Lew (Chepter 9(commencing with Sectian 7000) of Dlvislan 3 of the
Business antl Professions Code) or ihet he or she is exempt iherelrom end iha basis for Ihe elleged Baemption. Any violation of Section 7031.5 by any epplicent for a pertN'
subjecis ihe ep0�icant to a civil penelry oi not more than five huntlretl tlollars ($500).):
❑ I, es owner of the property, or my employees with weges es their sole compensailon, WILL DO THE WOHK, end the structure is not in�ended or oHeretl tor sele (Sec.
7044, Busineu antl Professions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves ihereon, end who does such work
himself or herself or through his or her own employees, provided ihat such improvements are not Intended or otteretl for sale. It however, ihe building or Improvement is
sold within one year of completion, the owner-buildar will hava the burden of proving t�at he or she did not build or improve for purpose oi sele.).
❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRAGTORS to construct the project (Sec. 7044, Business end Protessions
Code: The contracrore Licanse Lew tloes not epply to an ownar of property who bullds or Impmves Ihereon, and who coniracts for such project wlth e coniractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for ihis reason:
Signature: Date:
Owner ID ventied by driver's license. ❑ Yes ❑ No Drivels License No. Expires:
Vedfication of Ownership by (rype oi tlocumen6 I.e. - proparty tax bill ar tleetl):
DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFICATION:
❑ I hereby certity ihat no excavation five (5) or more �eet in tlepih into which a person is required to descend, will be matle in connection with work euthonzed by this
permit, and ihat no building siructure, scalloltling, talsework, or tlemolition or tlismantling thereot, will be more than thirry-si: (36) feet high. (Chap. 32, Grp 2, An 2, Sec.
341, lltle 8, Califomia AGministrative Code).
❑ As owner-builder, I will not employ anyone to do work which wouid require a permit trom t�e Division oi Intlustrial Safery, as notetl a6ove, unless such person hes a
permit to do such work irom the division.
Signeture: Date:
Division ot Industrial Satery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AIJfHORIZA710N OF ENTRY: I certity under penalry ot perjury that I have read Ihis application and state that the infortnation given is
correct. I egree to comply with all state laws and ciry ordinances relating to �uilding construction, end authodze representatives of the Ciry of Costa Mesa to enter upon the
ebove-descnbed pmperty for inspedion puryoses. I egree not to occupy or ellow occupancy ot any building euthonzed by this permit until final inspection.
COOEI, INSPECTIONTYPE
1616 Pixed System Final Fire Preventian
1266 Paal Spe Final
200 Finel Re-Root
201 Finel BIocWRetaining Wall
202 Final Factory Fira Place
203 Final Sign
204 Final Demolition
Q�jfi INTRIALS
/a � / � i ate
l/'
Date
COUEN INSPECTIONTYPE
206 Finel Mechenical
208 Final Plumbing
210 Final Electrical
212 Final Flre Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
URTE Uf7II19L$
AVO���ant to fill in all
CITY OF COSTA MESA PERMIT NC
CONSTRUCTION PERMIT T�—a�
Address
License No.
Address
Contrector
n Address
within �eavy EorEer lines anE zign all apD�ooriate tleclarations.
TRACT NO. LOT NO. BL�G. NO.
l 1 heraby atfirm that I am Ilcensetl under provisions of Charter 9(<om-
\ mencing with section 7000) of Divlsion 3 of the Business antl
Protesslons Code, antl my Iicense Is In tull torce antl effect.
�u�ao:a ci �: C36 —,;� , No 151839
Date 4 5 55 Slgnature >�l A� ��%A"�/�
WORKERS' COMPENSATION DECLARATION
I hereby af(irm that I have a certiiltate ot <onsent to seltdnsure or a
c¢�ti(I�te Of WOrke�S' Compen5ation InSurance, Or a tertifieG CoOY
thereof (SecNan 3800 Lab. C.�.
�•.,ucr No.2M 91 �i comoanv G*ahP (`nmz _ Tna
:erUtietl copy i5 her¢by (urnishetl. .
Eertitietl copy ii tiletl with the tity Builtling Division.
EXEMPTION FROM WORKERS'COMPENSATION DECIARATION
(This 58Ctlon n¢Gtl nOt D¢ cOmpletetl it tne pe�mit Is to� one huntl�2tl
SSI00) or less�.
certify that In the perto�mant¢ ot th¢ wOrk fOr whiGh thi5 permit is
IssueE, I ihall not employ any person in any manner so as to become
subject to the Workers' Compensation Laws o( California.
Date Signature
NOTICE: If dit¢r makin9 thi5 tletldratiOn, you shoultl Decome subje<t
to t�e Workers' Compensation provisions ot tne Labor Cotle, you musi
fOrthwith comply with such provl5ion5 Or this perrtlit shall be tleem¢tl
tevOketl.
CONSTRUCTION LENDING AGENCV
I her¢by affirm that there Is a con5tructlOn lentlin9 a9enty for th¢ per-
forman<e of the work for which this permit is iszuetl (Section 309�
Civ. C.).
Lentler's Name " � - '
Lentler's Atltlress
OWNER BUILDER DECLARATION
I hereby attirm that I am ezempt from the COMractor's License Law for
lhe (OIIOwIn9 r¢d5on (5¢Ctlon ]031.5 B�SIneSs antl Profe551on5 Cotle:
Any cl[y or COunty which requires a permit to.construct, alter,
improve, tlemolith or repair any structure, prior to its issuante, also re-
qWres the appllcant for such permit to file a signea statement tha[ ne
IS IICGns¢tl pur5uan[ to th! provlSiOns of the Gontractor'S License Law
(Chap[er 9(commencing with Section 7000) of �ivision 3 ot the
Buslness antl Prdessions Cotle) or that he I5 exempt theretrom antl the
ba�is tor the allegetl ez¢mption. Any violation of Section ]031.5 Dy
appli�nt fo� a pe�mi[ subjects tne applican[ to a tivil penalty
�l more than five huntlretl tlollars (5500).
L., a5 owne� of the prope�ty, o� my employee5 with wages a5 their
sOle COmp¢n5dtion, will tlo the work, antl (he structurC is nOt intentlea
or offeretl for sale. (SecHon 7044, Business antl Professions Cotle: The
Coniracior'S LlcCnse Law tloes not apply to an owner o( a proP¢r[y
wh0 bu1145 0� improves thereon, antl wh0 tloes suCh work himselt o�
through hi5 own amployee5, provitletl [nat su[h Improvements a�e not
int¢ntletl or off¢r¢tl fOr salE. If, however, the building or improvement
is soltl withln one year ot completion, the owner will have the burtlen
of proving he ditl nof builtl or improve fo� lhe pur0o5e of sale).
❑ I, as owner of the property, am exclusively mMractinq with
IiCensetl COnt�actors to const�uct the prol¢Ct (Section 7044, Business
� antl'Pro/essions Cotle: The Contractor'z License Law tloes not apply to
an owne� of property who builtls o� Imp�oves the�eon, antl who cOn-
tracts Irom such projecis with a contractor(s) Ilcesnetl pursuant to
IM1e Contracto�'S License Lawj.
❑ I am exempt unEer Section B. & P. C. for Nis
reason
Oate Owner
I hereby certitythat 1 have reatl [his application antl Siate Ihat the above
IMormation is wrrect. I aqree [o comply with all city antl county
ortlinances anU state laws relafing to construction, antl hereby authorize
reple5e0(dtives o( th15 city to enter upon th¢ abOve men[ioned
property for in}pection oses. . z�1•��8�
Signature (��• �� �����!'"
TVPE OF CONSTRUCTION
QJ NEW ❑ ADD ❑ ALTERATION
❑ REPAIR ❑ CONVERSION ❑DEMOLISH
❑ OTHER WatP7' }1P3tPT T2i �
�ESCRIGTION OF WORK
9'VPE OF PERMIT
❑ GRADING ❑ FOUNDATION ❑ STRUCTVRAL
❑ TENANT ❑ EIECTRICAL �PLUMBING ❑MECHAI
❑ OTHER
PROJECT DESCRIPTION
SQ. FT.
OCCUPANCY_CONSTRUCTION TVPE
VALVATION ZONE
GRADING CV. VDS. ACRES
l2EMARKS:
PLUMBING PLAN CHECK
BATHTUBS $HOWERS
TOILETS URINALS
LAVATORIES DOUBLE lAVS
KIT.SINKS DISHWASHERS
SERVICESINKS SVMPS
FLOOR.SINKS • � FLOOR DRAINS
DRINKING FOUNTAINS '
INTEIiCEPTORS C�ARIFIERS
$WIMMINGPOOL PTRAP
WATER $ERVICE ALTERATION
GAS SERV ICE
WATER HEATERS ],
SEWER CONNECTIONS
SOLARTANK
SOLAR PIPING SVS.
ISSUE FEE
OUTLETS
BTU OVTPVT
COLLECTORS �
MECHANICAL aLAn CHECK
HEATING SVSTEM 0-100,000 BTU _
AND DUCTING 100,000 + 8TU _
REFRIGERATION 0-100,000BTV_
SVSTEM �� 100,000+BTV_
BOILERS BTU
SYSTEM REPAIR,ALTERATION
EXHAUSTSYSTEM MVLTIPLE
ISSUE FEE
CMF 0865-46 White-Builtling; Canary-Appliwnt; Pink-Accountinq; Goltlenrotl-Assezsor
2927 3/05/82
ZONING REGULATIONS
A.P. �
ZONE PLNTGp. Rg�E/F�. p�
SETBACKC/LST. PROPE�RTVNLIN
SIDE VARD
L5EDFT
R�IGHTA
REAR YARD (TO P/L)
PKG.SPACERE�. PROVIDED
STREET WIDTH PARK FEE
ZONING APPROVED BV DATI
SPECIAL CONDITIONS:
ELECTRICAL PLAN CHECK
SCl FT. SO_ FT_
GENERATOR 0-1 KW_1-30 KW _
TRANSFORMER
APPLIANCE 10-SO KW_50 * KW _
MOTORS p-1 HP_1-30 HP _
(INC. SOLAR) - 30-50 HP 50 * HP _
FIXTURES OVTI_ETS SWITCHES
GAS TUBE SIGNS
POLE LIGHTS
POLES METERED SUB
PANE�S MAIN SUB
SERVICE ' ' AMP
ISSV E FEE
APPLICATION APPROVED BV
SUMMARV OF FEES
BUILDING
PERMIT S
PLANCHECK S�p��� �/�
PLVMBING $ �+•��
PLANCHECK S
ELECTRICAL 5
PIANCHECK S
MECHANICAL $
PLAN CHECK S
6.00 Tl
SMIP S
PERMIT
ISSUANCE $ "}��
G0.ADING S
E
MICROFILM $
TOTAL FEE S 6_ OO
LE55 AO� '
VANCE PC $ _
FINAL FEE E
CONSTRUCTION AND PLANNING � POOL & SPA'-',,` � ., , , �
APPROVALS Permit# Date Inspector pppROVALS � Permit� - Date ` Inspector
1. Temporary 6lectrical Service or Pole 43. Pool & Equipment Location�� � '"
2. Soil Pipe-Untlrgrn � .- 44.- Steel Reinforcement
3. . Electrical Conduit Utility-Undrgrn � 45. Forms ' -
4. Electrical Conduit-Undrgrn 46. Electrical Bonding. �
. tee ein orce 47. Rough Plumbin & Pressure Test �- �- ' ' '
6. Electrical U ER Grn � 48. APPROVALTO COVER-GUNITE ' "` -� �-- -
7. Footings 49. Electrical Conduit-Undr rn
8. Foundation 50. Gas Pipe, ❑ Undr rn, Test .
_ 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ Undr rn �" �
10. Structural Floor System 52. APPROVAL TO DECK �
11. Property Sewer Line & House,Connection . 53. Backwash & Rece tor-Final�
12. Street Sewer �onnection 54. Heater & Vent-Final
13. Rough Plumbing " � -' � ' '
� 14. Rough ElectricConduit - �56. Electrical-Final �� '
' 15. Rough Electric-Wiring 57. Solar System-Final
16. Rough Heating & Air Conditioning encing & Access Approval
17. Ducts, in Structure APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing � �
21. Roof Sheathin �
22. Frame and Flashin NOTES:
23. Insulation - 5/ZzJdy LEFT"' CR2p Grc��
24. lathing & Siding
25. Drywall Nailing
26. Plaster Brown-Coat
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating &�Air Conditioning ' " '
30. Final Gas Pi�e-Test
31. Final Plumbing y �
32. Water Service-Final
33. Gas Service-Final
34. Solar pomestic-Final �
35. landsca e S rinklin S stem
36:- Sound Attenuation
37. Handicap Regulations � ` ' "
38. FINAL STRUCTURE & BUILDING
39. Special Requirements Completed
40. .Electric Release to Edison
. 41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY . �
No Date ,
+ O '