HomeMy WebLinkAbout3041 LOYSBURG BAY - Building Permits t ` _
LEGION IRON
Fabricators of - 1838 Acre St.
Structural Steel Norco,California 91760
Miscellaneous Iron (714)735.8300
Ornamental Iron St. Lic.#285388
July 15, 1983
RE: Pentridge Cove
Randolph St. , Tract 10871
Costa Mesa
The Janes Co.
SUBJECT: SPLICING BEAMS:
Unit:-E, 4 each
Unit C, 1 each
Per plan enclosed drawings
Certified Welders:
Manuel Pena E 1739
Roger Kleppe E 5407
All beams spliced in the shop of a licensed fabricator.
Lot # 13 Permit B 7509
764 Windgate Bay
Lot # 15 Permit B 7511
3042 Kittendale
Lot # 37 Permit B 7534
741 Schenley Bay
Lot # 39 Permit B 7536
3057 Loysburg Bay
Lot # 47 Permit B 7544
3041 Loysburg Bay
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 PER IT — ?41 0 7 -
frOject Address ^� 0 a 'JIVs. TYPE OF CONSTRUCTION air NEW U ADD LJ ALTERATION LI REPAIR _
Applicant's Mailing Address -Ca III rMaU ieper. CI CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# • Zone '
Owner's Name hk DESCRIPTION OF WORK
- 'hone - S Main Building: Accessory Building';- .. o ':Z TI
•Address TYPE OF PERMIT GRADING 0
❑ FOUNDATION U STRUCTURAL E Front N
•
Arch/Eng. License No. _ - ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B I
A Rear • N
Address i_ / ❑ -OTHER
1 1 lJ� f 1��11 C Right G
Contractor's Nam• �-guy jp •�.� - J P c, .'i. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K -
`� 1f r"c�e�� CONSTRUCTION TYPE VALUATION$ S Left R
Address(mailing) )) E
City License No. l�I la- ZONE GRADING CU.YDS. ACRES Ping. Ref.4 Park.Fees $ Q
U
LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided - I
I hereby affirm that I am licensed under provisions of Charter 9 (commencing R
with section 7000) of Division 3 of the Business and Professions Code,and 2�/Z 4'r Use of Building: E
my license is in full • e an telt. T(f�-
LIcens�y las _ + — Licens- • "A �r,� PLUMBING FEES Planning Notes: E
Date f�� j� Signature �l�
• Bar Sink Showers N
WORKERS'COMPENSATION DECLARATION T
'hereby affirm that I have a certificate of consent to self-insure or arts Backflow Preventer Service Sink S
Workers' Compensation Insurance, or a ce�tl�leq copy�nere• (Se ton
—
300, Lab.µ)�I ITy:C2 _ \ Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No. W-3a..JdJ Company -�\ _
Cer ' ed copy Is hereby furnishes? pathtubs Sewer Connection I Automatic Washer Transformer
ertyied copy Is with the city uildi s" ,
❑ 15-50 KW
/ "1 [�� 050+ KW
Clarifiers Solar Collectors Construction Pole Sub.
Date Applicant _ _
EXEMPTION FROM WORKERS'COMPENSATION DECLARATI pD Dishwasher - Solar Piping CookingUnit Meter f0 100 amps(This section need not be completed if the permit Is for one hundreQ( 100) or P P
less). Drinking Fountains1
I certify that in the performance of the work for as which this permit is issued, I 9 Solar Tank - I Dishwasher Meter Dover 100 amps
shall not employ any person in any manner so as to become subject to the '
Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers Gas �E`lectric Sub Panel 10
Date Signature _ _ _
-
NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal Fan • Motors 00-1 HP 011/2-8 / -
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. •
Inc.Solar 09-15 HP 016-15+
CONSTRUCTION LENDING AGENCY _
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave 3
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 - ^,'
OWNER BUILDER DECLARATION Lavatories - Sys Outlets / Range 7 /0I hereby affirm that I am exempt from the CoP-Trap
License Law for the a —
` s
following reason (Section 7031.5 Business and Professional Code: Any city or p I D Switches Sign - A
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 / J
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 ❑0-5 KW❑5-15 KW. Trash Compactor
vision 3 of the Business and Professions Code) or that he/she is exempt : P
'efrom and the basis for the alleged exemption. Any violation of Section '
1.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee - $.3
rr��.aity of not more than five hundred dollars($500). pe $25 Issue Fee I
Ll I, as owner of the property or my employees with wages as their sole Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered MECHANICAL FEES
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 Date
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 corn- Duct- Under Ground Application Approved By Date •
pletion, the owner will have the burden of proving he/she did not build or im- -
trove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By v Al r Date -1/./4.4P-2
LI I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 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
builds or Improves thereon,and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $
tractors) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT
0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# PLUMBING $ ISSUANCE $
Date Owner Heating System& Ducting
PLAN CHECK $ ENERGY P.C. $ _
I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100.000 BTL '9 0 GRADING $
information is correct. I agree to comply with all city and county or•inances ELECTRICAL $and state laws relating to building constructi n .nor ereby a ze repre- MICROFILM $
sentatives oath ub' to enter •• b. -• p operty PLAN CHECK $ �.
inspection pur se
TOTAL FEE $ • 0
A` • � r `f MECHANICAL $ ‘CS.-- �
Signature • •ate Reinspection Fee $25 ` Issue Fee $ 3 PLAN CHECK $
I Drivers' License or
i
CMF 0865.46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor ",
CONSTRUCTION AND PLANNING • POO' WA
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, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap • 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final '
16. Rough Electric Wiring - • 1t'itr-'S3 CC 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ,
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 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 /% �e 80. FOOD CERTIFICATE ISSUED
33. Final Electric /i� Notes:
34. Final Heating & Air Conditioning •
35. Final Gas Pipe-Test -
36. Hood or Canopy
37. Final Factory Fireplace .
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation •
- '
44. Landscape Irrigation System
45. Sound Attenuation •
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co
51.'CERTIFICATEOFOCCUPANCY •
No, 'Date -1 •
AlApplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA • - • 0739 W 21 Ida ,34:1,1;' 1-
I� I PERMIT NO '/ - ITR T LOT O . , BL06;INO.
• CONSTRUCTIONPER�<. -y /27S' (-f L ry ' '.' ! vf�i • ! i
Applicant's Mailisi A•dress M •el i i �✓ d 0- •nP •TYPEOF CONSTRUCTION EW ADD UALTERATION U.REPAIR +
ProjecS.t Address,J.'� -���.�e ,'//41 MIS , yf $ ❑ CONVERSION ❑ DEM• 7 a - r • -
1 1 1 /��'r, DESCRIPTION OF WORK /• A IMP) /'/:I-_._1.__ IF. dmaliP
Owners Nam: ■1i /. , ,� - •LIL a • .L .
•Address • I]'��Alr Nl;7/O111F� j. it (Y� ■ e ►:� n'•:' --i A.P. . _ - _ •
����/� _ —� - TYPE OF PERMIT., ' GRADING FOUNDATION TRUCT - - ML 'J 'p'ZONE r_-
AfCh/Eng. �Y�YCpi"I�I'.'�I�e R' ¢�qS�e No/�K'I_],_� ❑ TENANT �❑ ELECTRICAL ❑ PLUMBING. ❑ ECHANICAL _ PLNG. REF.SY•- -. / -�'T(J 'BUILDING • �� - • ,
Address: ` r • i -O, VI -VE i ❑ 'OTHER TO BUILDING -
ContiectorsNern- - file \, ^Phon��t�� PROJECTDESCRIPTION' •
SQ. . lb1�7S 7/,1 P-•'Es V _INE.... L- I' / REAR YARD(TO P/L) � "
���I��•CCUP Y
Address(mailing) I • I - >' 'CONSTR TION TVP
f VA • ION S - LEFT SIDE YARD ��_ / �_ m_.1 HT SIDE YARD � / ' ' ' ad' '
1 - 1 _ ' - I ZONi3 r ' GRADING CU-YDS: a ACRES PKG.SPACE'REQ. / PROVIDED Oa -
License No. . . j• 1 ''4" _ : %'�. L�lPr w
LICENSED CONTRACTOR DECLARATION I - ' Remarks: I - STREET WIDTH PARK FEE,$ , w's
I:hereby'affirm that 1 am licensed under provisions of'Charter 9(commencing ' { s� / / �/•
with section 7000) of Division 3 of the Business and Professions Code,and • - i , • ' SPECIAL CONDITIONS: _ _ s a '
my license'is in full force and effect- - _ -
IJcansa Gass License No.. PLUMBING how CUI( J�GI.INI.�WY,�+ " �'S, - I
• • c:
Date Signature I ' Bar Sink Sewer Capt ' i 4 . ' ELECTRICAL i • , i
WORKERS'COMPENSATION DECLARATION ' - - - •
ereby affirm that,)have a certificate of consent to selfdny n a certificate_I Backflow'Preventer•-- -• -'- - Sewer Connection'-- - -- -- Automatic Washer ,,,�. r-I_r _ ;Meter Clover 100 amps _ ! r 1 •
Workers' Compensation Insurance,'or a certified(Copy thereof (Section 1 - .. • - ,
- - Construction Pole ! ;Sub Panel. •
_000, Lab. C.) I I Backflow Irrigation . Solar Collectors` _ -_ �- •
•
-
oo Fy No. Company 1 - - CookingUnit ' '1Sub Pole ' I r
J�..Certified•copy Is hereby furnished. , ; Bathtubs ! I Solar Piping - ',"! ^I `' 1_ - 1 •
rr,LLLJJJ Certified copy is filed with the city Building Division. I i I I Solar Tank d- Dishwasher Motors ❑0-1 HP ❑1X$ r
Date 1 • Aupiicent - - • i - Clnrif{ers i ! •
EXEMPTIONIFROM WORKERS'COMPENSATION DECLARATION - t• Dryers'❑Gas'❑Electric 44 Ibc.Soiar,❑9,15 HP 015-15+ '
(This section need not be completed if the permit Is for,one hundred ($100)or Dishwasher ! : ! , Swimming Pool w/Spa
less); ' Fan' I 1 I I Microwave " •
;
-_i 7CONSTRUCTIONAND:PLANNING '6 -- - , - POOL '"SPA - - _ _c
, O I s- r i r' = r ; iDate ` - ;Inspector �r- : _ - '.Date Inspector
> _APPROVALS = Permit# .''APPROVALS 'Pert n#- -
n '1: Tempoiary,Electrical Service or:Pole 1 ;: ;, c' _;C: :52'Pool &:Equipment_Location, -
�' 2'. ISo11 Pi a-Undr rnd:' - o; d'- ? . a - - - _ - , ' I ..
_ I _ P 9 - ' 1 e ! i>• „l. '53. Steel Reinforcement • •
.a ,3. Electrical Conduit Utility-Undrgrnd. Li; k 1 ri. 1 ,..„7 °_-2 .b4.. Form's- - _ ,- -i -
:4'
Electrical Cond =uit-Undrgrnd. @ ' >. -55-o Electrical Bandin
5:Steel.Relnforciement r1•1i ' - - I c ^ r ' .56. Rough:Plumbing.&PressureTest - �i1
6:^Electrical UFER'Grad! ` -•''' 01 ` - - • 57' APPROVAL TO COVER-GUNITE: - i 1' _
7.'Footings'.( '^ice ,I t"`i � & � ` r 1• 722 i S ` I 58. 'Electrical CoT.
nduit-Uridrarndt ; -
8. IFoundatiori -- ^4 -• q i - o ; ' -59. Gas Pipe;:,0 Undrgrnd.,Test- ; ' •
9. Water Pipe=Undrgrnd. ; r. - a :8- 1 r,, , , ; }60. ,Backwash Lines,iP-Trap, 0 Undrgrnd.-
10. Structural Floor System 1 I ? d= ; 7 61. APPROVAL TO.DECK • - -
11. Property Sewer. Line &IHouseConnection a ; i; i 62. `Backwash &,Receptor-Final • - -
12. Sewer-Cap' 2 . I • a • ; -r, I '63. Beater&-Vent-FinaI ; Y. - •-, - .• ,
r1 I I 1 9' . '-4 ^-c . - - *
13.-Roof'Drains ,r`.I : 's;-; j °o '64. Plumbing:System -Final - • •
4 14.IRoughi:Plumbingl '- I _ - 2 i - -% 65. Electrical-Final - • ,
+
n ,f15 Rough•Electrical:Conduit l-11-7.1- r I- - 1 1 - 166.' SoIaiIS9stem-Final
.;16:-Rough-Electric Wiring, A I .`. I II '11`-, tr:!• t�
, c" 9 &67T Fencin 'Accsspp
e - Oval: - - _ • : 1 - - -9n .h'. vial , •rI - l- tt•;--kr - - ..
;i7r'IRough-wiriin•'g Sign' . ' I ' I I : •1 ' T I " 1 j 1 1681 APPROVED FOR PLASTERING - ' ' - . •- _ ' -
18. IRough`Elctrieal;J'Bai.Ceiling I. ,1 I :,, I,-; I I I e - I • ;69.! ROOL/SPA SYSTEMS FINAL : ' ' ' ' -
II 19.'Roug Heating & Aiir_Conditioning ' ' :.:11 I I 1 I I 'FIRE DEPT. REQUIREMENT •• . _ -
. ; ?O. RoughFactory Fireplace ` ; If it ; I I 1 1 - l 1 APPROVALS Permit# , '__ 1
i. -, . l' , - - , 1 ; .; I ! I I I 1 I I 1 I I
1 21.IDucts`in Structure' n, I1•. °11
I I l , •
170 1 Underground Hydro
?I22.'Duct l .Ventilating :' ' I I II I I i I 1 1 1 71.,. Product Piping 0Gas 0Oil ' i , - .
23}Gas'Pipe-Rough &.Test : ; 11c I T , 72.I Undergro-untl Flush'
-. ,
1 • -I - 1 1•l I I I I ( 1 .
l 24.;Root Framing, ,��,1?-„ I I l e 1101 , ' I';.' I_j;d O , I ?:' 73 Undergrnd.Storage Tank 0 Gas .p di
g 25..Roof"Sheathin 1 ' 1 'r-: I ; ' " '-'' 1 I I -
.. a__... ,� -. � 9 .__ � I 1 11I� ',] I_ Ir EI � �74: OverheadHydro
1-26T-Ban Ceiling (Structural);& Monocoat I I : 112 rJI II: 1 75. Dry Chemical . .
i '^27. ,Frame and'Flashing,-,. .1_I l ql I g,/� ' 76., Dry Standpipe { ,
,
L 28 01ething &'Siding t 1 I ' 1 I • ' ' 177I FIXED SYSTEM-F;INAL - I
, 29 :Insulation -1 - 1 _ - „, I II ',! I
_ i 1 I - , 178 FIRE PREY. FINAL
;n 30. ;Drywall Nailing • m, ^( l 1 411.2.0y Wa' IN tes: I ' -
1
_. 31.'Plaster'Brown Coat 1 ' ' II • I I y-- - .I ; ' I o' 1 ' -
1
�1 , 32.1,Electrical,Power Meter-Final I 11 I I 11 1 I ! I I I
33. Final Electric • 1 ' I I II 'I I.
' , I ' 1
34. Final Heating&:Air Conditioning I! I , I I , l I I ! ' '_ - '
•35. Final Gas:Pipe1Testi I: `` 1'4: - I - ^' .g 'I i I,_ �' I I I - -
G o l
36. Hood or• lCanoPy..1 m 1 ' ' r. 11 I it _ I Y' 1 .- _ 3 i _ I ! I , i 1 -
_ 11 '•l l '. I n 11 IL I I I I .I ,
37. Final FactoryFireplace '= ' S! ,I ' ' = 1 ` - - ;
38. Final dumbing I I ..a i , ' ', U ' ! I , 1 ' I I 1 I I I r- ' . I - ' - '
39. Water Service-Final, 1 ' 1 f- ,II� I 1 I -- I I ' 1 ' . • •
I 1 I'_.
40. Gas Service-Finl _I I � l" I I ' I 1 ! .. I I ' I I
41. Solar Domestic-Final. ' I '1 l l l 1 ! 4_ . --+--2- -�- :_ -- •+.' -; ' I
42. Backflow Rreventer,a .4 tf_ 1,.. 1 11 ; __H__.'_- _ -_ ._-1_,l ..i .1_ .1.. 1 - , • ' • -
43. Backflow,Irrigation ' 1 I 1 ' .,;1 „ , ---.1.1t.yr: .C. 1 ' -+1 ' I •
1 r 1 '
44. Landscape I• r •rigationc•System 1. 7c,1.. t i a I : ! :a, -- I �; : I -
45. Sound ,Atteuation > I i. I ; t' i 1;1 -..; 1 j:
?gip, , 1- I I - I
46. Handicap Regulations I I I I-. �11 I:- 1 'r•I I - I ' - .. -❑ '
47. FINAL STRUCTURE& BUILDING;, I -cc/
-''� C' I I '- '
•
48. Special Requirements Completed ,�iI��SM 1 I _glee ,&�1 I 1 , • 1 ; , ••••• . •
49. Electric Release,to Edison 1 ! " I �I .� 1 I t r I__-I-_ _ __. _., .. - - i
50. Gas Release to Southern California Gas Co I 1 I I ' ' i 1 1 1 ' ! l • ..
. 1 k 1 - I ,
51. CERTIFICATEOFOCCUPANCY ; ` _I_,.t� I -
1 _ : ; . :
No,
n ,1 Date ( r , I , i ' '
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CI .1 PERMIT NO. . ,TRACT NO. LOT NO. BLDG.NO. O(�0%, Gla//i3 ��a,l'f- T�..
CONS J PERMIT - - a 7t Qom' - .
Applicant's Mailin Address Yl) IyI Q� ' 5t�lPf TYPE OF CONSTRUCTION II4INEW LI ADD LIALTERATION LI REPAIR
\ Project Address t/1 I0 is 4^3 V2P\) �,r` � /- ❑ CONVERSION ❑ DEMOLISH 0 OTHER • - -
�j\ I�eS ICO Phone(] r 33% DESCRIPTION OF WORK
Owner's n - i ZONING REGULATIONS.
v Address rl� !-f'I QGUA"y (7In - .
z TYPE OF PERMIT Ll GRADING U FOUNDATION LI STRUCTURAL A.P.rM ZONE •
..„ Arch/Eng. -License No. 0 TENANT 0 ELECTRICAL' W.PLUMBING 0 MECHANICAL PLNG.REF.94- _ -• -BUILDING
•Address . • ❑ OTHER / - • TO BUILDING •SlCTR^rv' r,s ST
•
Contractor's Name Kin 1 q ��� �L� PhoneG7�y'3�1y-�sX/^7 t. - PROJECT DESCRIPTION SQ. FT. ' OCCUPANCY PROPERTY LINE
_ ' .REAR YARD (TO P/U ' • i - •
1�.v 18'7 , Mwi .n - /O(A�V , CON STRUCTION TYPF ' VALUATIONS LEFT SIDE YARD •
RIGHT SIDE YARD ..
Address(Mailing/ - - •
-x, , _ , ZON€ • - - ' GRADING CU.YDS. ACRESr PKG.SPACE REQ. PROVIDED
License No. '' (/ /( - - - • -
LICENSED CONTRACTOR DECLARATION Remarks: • 675`1' STREET WIDTH PARK FEE$
I'hereby affirm that I am licensed under provisions of Charter 9(commencing -
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: - - ,
my license Is In full fore and effect. • - - - -
License Class C' /7 Ufense No: kg/5901 I • PLUMBING I
Date CO'/' -Ai Signature/ �� ,j XX) Ory'le sr'p'tr- '
WORKERS'COMPENSATION DECLAPATION 1 ' (/ • Bar Sink Sewer Cap 1 ' - ' ELECTRICAL
•
hereby affirm that].have a.cartificate.of consent to selfinsureor a certificate _ . . . - ; _ . .__ Automatic Washes - - - - 'Meter Dover 100 amps_ -
Workers' Compensation insurance„or a certified copy thereof (Section ' BackflOw'Pr¢venter - Sewer Connection' - -
..800, Lab. C.) • < f Backflow Irrigation Solar Collectors Construction Pole Sub Panel •
Pollcy No, .n U.h/303NA Company ill�SfOn' •r I - -- --- • ' ''rr
Certified copy Is hereby furnished. n . ! .- Z Bathtubs q Solar Piping : .5c, Cooking Unit I Sub Pole •,
Certified copy!Oiled with the city Building Divi / Dishwasher • - Motors ❑0-1 HP ❑1`l,$ •
ate
Certified copy
I Applicant •111 - XA•�11J /Y/N id-44 . Clarifiers I Solar Tank , I r
EXEMPTION.FROM WORKERS'COMPENSATION DECLARATION ,� Dryers ❑Ga5' �Electric 'Ina Solar`09-15 HP 16-15+ ''
(This section need not be completed If the permit Is fort one hundred($100�r /, Dishwasher i •
Swimming Pool w/Spa ' a 1
less) - ' I •��// r - Fan I , 1 'Microwave , 1 '
I certify that In the performance of the work for which this permit is issued Drinking Fountains Urinal
shall,not employ any person In any manner so as to become subject.to the, I F.A.U. I , i Pole Li ht
Workers' Compensation Laws of California. ? Floor Digins, . 2 Water Closet. , I - - -- - 9
Date Signature - '
NOTICE:If,after making this declaration;Youshouldbecome subject to the- Floor Sinks I - - Water Heater --- - - .. - Fixtures _t ._J Range.-_r- f _- - _ _ . ,
Workers' Compensation provisions of the Labor Code, you must forthwith a - - Device Boxes I , i +
comply ;with such provisions- or,this ,permit shall be deemed revoked: I Gas Service, -Outlets Water Service , ry i _ i Sign,
CONSTRUCTION LENDING AGENCY - - Outlets
I hereby affirm that there Is a construction lending agency for the performance Interceptors - _ _ I ' Standing Sections ,
Of the work tor,, which this permit Is issued -(Section 3097' Civ. C.) - • $witches
Lender's' Name - f. - / kitchen Sink - I eat Trash Compactor •
Lender's Address '
Lavatories • I Garbage Disposal
OWNER BUILDER DECLARATION " '" '- • C. I I 1 — -
I hereby affirm that I am exempt from ss ntraclor's License Law for the P-Trep - Generator ❑0-5 KW ❑5-15 KW
following reason (Section 7031.5 Business and Professional Code: Any city or ' i ^
-county which requires a permit to construct,alter Improve,demolish or repair „ _ Transformer 015.50 KW - •
any structure, prior to its issuance,also requires the applicant-for such permit ' Roof Drains` ' -_ : - . '
to file a signed statement that he/she is licensed pursuant to the-provisions of - - - - I 05U+ KW' Reinspection Fee
-the Contractor's License Law'(Chapter 9(commencing with Section 7000)of ' - sPe $15
;Piston 3 of the.Business and Professions Code)-or that he/she is-exempt ' / Showers is , '.1 7 j Reinspection-Fee $15, - '
'-:efrom and the'basis for the alleged exemption. Any violation'of•Section - Meter ❑up to 100'amps Issue Fee • .$ 3
..;-.1--11.5 by-any applicant for a permit-subjects the applicant to a-civil - I , T
natty of not more than five hundred dollars($5001-
6„
$500). - Service Sink! '" • - Issue Fee $ 3 Zoning Approved By •Date
I,-as owner of the property or my employees with wages'as their sole - - '
, compensation will do the work,and the structure is not intended or offered ! ' e i • - MECHANICAL Application Approved By Date '
for sale (Sec/ion 7044', Business and'Professional Code: The Contractor's _
License Law does not apply to an owner of a property who builds or Improves ' i Boiler "' I Refrigeration System A •pplicatiOn IssuedI / p
,
. thereonand who does•such work himself/herself or through his or her own '� li(at OI pp By
' , '' J. Date 7-0
• employees, provided that such improvements are not intended or offered for j ❑0-100,000 BTU ❑100,000 BTU' `
sale. If, however, the building or improvement Is sold within one year of com- Duct-Under,Ground SUMMARY OF FEES
pletion,the owner will have the burden Of proving he/she did not build or Im- ,
-
aqve for the purpose of sale). • , I i r Duct-Structural System RepairlAlteration •I ?BUILDING PERMIT $. ' . S• MIP ' $ •
U I, as owner of the property, am exclusively contracting,with licensed con- I
' tractors to construct the project,(Section 7044,Business and Professions Code: _ Duct-Ventilating . - _ f i ,PLAN CHECK; • $' �•o 1 PERMIT I
' The Contractor's License Law does not apply to an owner of property who • O�/�, ISSUANCE $ ' •
-
' builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 I • PLUMBING $ ry
tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $I / GRADING $ -
•
❑lam exempt under Section B.&P.C.for this reason Firepl/Fact.Bit.ICBG# 1
I • • :• ! .ELECTRICAL !- $'
Date Owner '• - Heating�System&Ducting I ? MICROFILM S I• i '
I hereby-certify that I have-read this application and state that the above -- 00.100,000 BTU 0100,000BTU - - - - - ' - - • PLAN CHECK - $.
Information is correct. I agree to comply with all city'and county ordinances i ! , 1 ! I TOTAL FEE! $
Information
laws relating,to building construction,and hereby authorize repre- ' MECHANICAL 1 $ .
. sentatives of this city to enter upon the above•mentioned property for ; Hood or Type I ❑. I Reinspection Fee I $15 . LESS '
inspection purposes,3.) I . f t ! Canopy Type II 0' PLAN CHECK 1 $, ADVANCED PC $
I Signature La / _ J_ / ') ' DAG U'��7 s1; r- 1 -
' Drivers' Llcen`se or SS V Registers I Issue Fee t $ 3 - ,
. ; FINAL FEE' $ 3n
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - -
lh nCONSTRUCTION AND!PLANNING - = ` -> --r - ,; _ _' POOL 'A •' -
- C"--:, - Id ' ' c - ° .`Date - ^%Inspector - - - Date Inspector
•APPROVALS , Permit:# - - APPROVALS: Permit# - -
Temporary Electrical Service or?Pole it' , - X52; Pool &tEguipment Location '. - ;'
n
;Soil Pipe-Undrgrnd;; _ 2. ' Rr 66/10/9.3 '°r 53" Steel Reinforcement - '
: Electrical Conduit Utility Undrgrnd: 5 "; ` - ?..!;•; 54:. Forms - - 'f - , .^
4. Electrical Conduit-Undrgrnd',-� - c y
` _ 55 Electrical)Bonding ' - - - '
b,. Steel c - -I _ ,,t - 56 •Rough Plumbing;& Pressure Test r
6. IElrectrical UF ER�Grnd. ', a ,j.= .7 '' L, - . 57; APPROVAL TO!COVE R-GUNITE •
7. Footin s ' = `•'. - - - _
g i , 4 , O •_ ;^' . 58. Electrical_Cpriduit-Undrgrnd.
8. Foundation ' 2 i v ' ' -it 4. - .-,, I .59. Gas�Pipe, 0'Undrgrnd.,Test
9. Water Pipe-Undrgrnd: : o • • 'S E, . - :60. Backwash,Lines,P-Trap, O Undrgrnd. .
10CStructural Floor System l _ - t --.-•,, : .61. APPROVAL TO DECK ' •
11. Property Sewer Line &11-louse'connection 8 _62. Backwash & Receptor-Final--,
12. Sewer Cap 1 ; 1 _ i 5 ^-, '63. Heated&:Vent-Final. -
13. :Roof,Drains !• ' I ,� 33 64. Plumbing;Systerri- Final - - ;•
•
14. Rough;Plumbing' - • -b4s'4i `k/W. :65. Electrical-Final 1 - - Lc/15 -Rough Electrical:Conduit f,1`-*1-. -7--!-f,-r- /_•T CT J66. SolaoSystem-Finert - .
! LI
•;4;:•16 'Rough;Electric,Wi• cing, H ; E ' ;i I -t �1-- '--, = - -!��,'- 17 X67: Fencing•&Access Approval -
7. Rough Winrig`Sign'? l �• ! - ;'. _' ;.-_ ' 68i APPROVED F,OR-PLASTERING" -
r .
- 18,.'Rough,ElectricaltT,BarCeiling! I'. ! : i I = I E N 69.I P00L/SPASYSTEMSFINALj - -
, 19.•tFoughhHeating &;AiriConditioning ; IRI I I; i i • FIRE DEPTJREQUIREMENT : - '
. '' ?0-,Rough Factory Firepllace i I! 1 I
' I I I ' ! I APPROVALS ! Permit#
1 21. Ducts;in Structure;, '" ` I 1 . ' ; I 70. Underground Hydro •
J
;22!Ducts, �Ventila`ting : ; 1 .. �I �; I I I I ; I I I71 1 Product Piping 0 Gas 0Oil
`23.'Gas Pipe-Rough&Test `, i 1;, T-l ._ i- ",3 72.; Unde'rgrounii Flush
1
r 'I-24.t-Roof Framing• , 4-4 1 -1 !a;, %-, I:t I:- ;I "H I --1 c 03.1 Undergrrid.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing , ;' I ` 1 - 1 o i ` I 174: Overhead Hydro _ '
L � : Q
^ ',-26. 1T,Bar r Ceiling'(Structurall:& Monocoat- 1 'j r, I r t 7 ' Dry Chemicsl - '
11.27. ,Frame and!Flashing ? . I i I IFI 1 Y! 1 176.', Dry Standpipe
28.:Lathing &Siding : , I I ,I 1 , ' I i 177.: FIXED SYSTEM;FINAL ,
29. yfnsulation i; i
.' I 'I I III ' I I ;78: FIRE PREY. FINAL '
o "t30.'Drywall Nailing ' ' I I 'I I j I I 1Notes: ' y '
%...*
• L31. Plaster Brown Coat' ' i I 1 1 I I , ! .._7 _ ..T ,.
i
It 32.iklectriral,Power Meter-Final i i 1 • I I l '
_ .L33.'Final Electric _ IJ_ � !I �_ I_,.-L I .�L I_ ILl
• 34, Final Heating & Air Condit oning ! I . I I i i 1 i i !'
35. Final Gas Pipe=Te'st '- j I re ' " !o I ' _ - - ' -
36. Hood or'CanopY''"� 9 I T' I - ' r• r ' f: I - i S y I ! - i - ' 1 i L . ,
i; '' , 1 I : 1 _ _ I" 1 I -
37. Final Factorirep -lace: 1 I '� ;1 . I. . ! , ' _
y Fr
38. Final Plumbing i i I I sl ; 1 - '7`/�TJ/j7 ; -; r' ' I - 1
39. WaterService-Final r
r r } I i I ( 1 • -
40. Gas Service-Final ! E i
41. Solar Domestic-Final 1 ' ' i'
--
42. Backflow Preventer c I - 144 ' t t - - -
43. Backflow Irrigat ion 1 I wd,l: - II.' '4:• : I 1 I ,,! •'
44. Landscape Irrigation Syytem l , ,�I_ ; Hi i ' ; ' 1 .,, ' I r•I
45. SoundirAttenuation',." 1m � ' 1 ,I f , - 1 J -
l 1 ' t I _
46. Handicap Regulations'; 1 r h 1 - 1 r ' , �i! 1
u _ 1 1r, . , 1_ T. r !
47. FINAL STRUCTURE& BUILDINGS' ! ' 1 .; ! , r 1 -
,48. Special Requirements Completed_ I
u „ I 1 ' 1
49. Electric Release to Edison ; ; L-_II4 _' I_ i-_1 i . ._
50. Gas Release to Southern California Gas Co I I ! I ' 1 I s ! 1 I • .! ,
51. CERTIFICATE;OFOCCUPANCY d -.-L_.:_4' __L__;- ' ' '
No, !; f; 1 I 1 r ' l { -�
Date ( J y 1
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - - - -
CITY 9F COSTA MESA as-' •I T• e PERMIT NO. - TRACT NO. LOT NO. BLDG.NO. I - ).,
CONSTRUCTION PERMIT • /I/1 — 7? 3 ZS rI
Applicant's Mailing Addressn
RataV a, ,Or• gc TYPE OF CONSTRUCTION NEW U ADD U N U ALTERATION' REPAIR '
Project Address 3041 j,pyshurg fay El CONVERSION ❑ DEMOLISH ❑ OTHER -
•
Owner's Name hone 1 - • DESCRIPTION, OF WORK metal fireplace •
ZONING REGULATIONS
Address. TYPE OF PERMIT U GRADING- U FOUNOATI911 U STRUCTURAL . A.P.# 'ZONE .
•
Arch/Eng.- . License No. • Ci TENANT El ELECTRICAL 0 PLUMBING' WMECHANICAL PLNG. flEF.REF.* BUILDING
-❑ OTHER CFTaAC1cJ CT •
Address' - PROPERTY LINE ' REAR YARD (TO P/L) -
Contractor's NameC08.St Fireplace . Phone 639-1[8[2[0 PROJECT DESCRIPTION SQ. FT. OCCUPANCY _ ' - -
A•ddress'(mailing) 1080-N j`1. �,t:A VIA Q�'AYIg 9266 _ CONSTRUCTION TYPE VALUATION$ - LEFT SIDE YARD - RIGHT SIDE YARD -
LcebseNo. 164OE7 ZONE - GRADING CU.YDS. ACRES PKG.SPACE REQ. PROVIDED
LICENSED CONTRACTOR DECLARATION Remarks: 6 - 7��/y STREET WIDTH PARK FEE$ - ,
I.hereby affirm that I am licensed under provisions of!Charter 9 (commencing 7 /
-
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: -
• my license is In fullAorccpp and effect. - '
License Class . - o. 6 PLUMBING ,
Date AM 5ignatura 7 .. c....c....11. - . �G'�
351 - -
WORKERS'COMPENSATION DEC • R TION / Bar Sink Sewer Cap ELECTRICAL
•ereby affirm that I have a certificate of consenttoself-insure or.a certificate- Backflow Preventer ,. Sewer Connection - - - - Automatic Washer -. Meter Dover 10n amps ... _ ,- _
Workers' Compensation Insurance, or a certified copy thereof (Section -
.0300, Lab. C,)517304 830CCA/t QJC Backflow Irrigation Solar Collectors • Construction Pole Sub Panel
Policy No. - COMP nY - - - - -
Bathtubs - Solar Piping Cooking Unit Sub Pole 1
ii Certified copy is hereby furnished. P 9 ;
Certified/op I filed with the cit A ding i :s
Date lit Applicant �/rs �j� Clarifiers Solar Tank Dishwasher : Motors ❑0-1 H_ ❑i'b-8
EXEMPTION.FR M WORKERS'COrrthhhAAA111///ENSAk ION DECLARYaTION Dishwasher , Swimming pool w/Spa Dryers ❑Gas ❑Electric - Inc.SOlar
(This section need not be completed if the permit is for one hundred($100)or _l ❑9-15 HP ❑16-15+
•
Iacertify that in the performance of the work for which this permit is issued I Drinking Fountains Urinal • Fan - Microwave
snail:not employ any person in any manner so as to become subject to the - - - - F.A.U. I• 'Pole Light
Workers' Compensation,Laws of California. I Floor Drains Water Closet ' I - 8 , ,
It; n this-declaration.,you should become subject to • l
after maksNOTICE:Compensationthe- Floor Sinks ; - --- - - - -Water Heater - - - - . Fixtures -,- - .;Range -.: __ '
Workers'
9provisions of the Labor Code, you must forthwith - Device Boxes . •
comply ;withi such provisions or this.-permit shall be deemed revoked. Gas Service. ;Outlets - • Water Service ' Sign
CONSTRUCTION LENDING AGENCY Outlets '
I hereby affirm that there is a construction lending agency}or the performance I , Interceptors l _ - - i Standing Sections •
of the .work for which-this• permit Is issued (Section 3097 Clv. C.). ' , ,
Lender's Name' - Kitchen Sink - • I Switches • t .Trash Compactor ;
Lender's Address - •
I Lavatories,. - -• • Garbage Disposal I '
OWNSR'BUILDER DECLARATION ' •• . .
I hereby affirm that I am exempt from the Contractor's License Law for the ) P-Trap • r Generator OBIS KW ❑5-15 KW
• following reason (Section-7031-.5 Business and Professional Code: Any city or ,. - ,
. county which requires a permit to construct,alter Improve,demolish or repair - I • Transformer ❑15-50 KW • • '
:'any structure, prior to its Issuance, also requires the applicant for such permit , 1, RdOf Drains - - 1 ' '
, to file a signed statement that he/she Is licensed pursuant to the•provisions of - � ❑5U(KW, $75. •
tie Contractor's License Law(Chapter 9(commencing with Section 7000)of . - • - - - I - 'Reinspection Fee
41t- ftom and f the
het-Business
fort e d Professions
legedlexemptiion. Any.or violation of•Sshe is ectipton - Showers Reinspection Fee $15 M• eter ❑up to 100:ampi - 'Issue'Fee. '$ 3
-,AS,�,; 5 by 'any applicant for a permit-subjects.the'applicant to a civil -
U6ilalty of not more than five,hundred dollars($500). • • r Service Sink " ' * - , — ,
00 Issue Fee $ 3 Zoning Approved BY Date
I, as owner of.the:property or my employees with wages as their sole (
compensation' will do the work,and the structure Is not intended or offered 1 ` MECHANICAL Application Approved By 'Date
for sale,(Section 7044; Business-and Professional Code: The Contractor's ' - 1/.�1
License Law does not apply to an owner of a property who builds or improves l • goiter' Refrigeration System : Application Issued By ^f/ ?/ y/9�/8� '
thereon, and who doe5,5uth'work himself/herself or through his or her own PP - Date
employees, provided that such improvements are not intended or offered for ❑0-100,000 BTU ❑100,0008TU
sale. however,the building or Improvement is sold within one year of tom- Duct-Under,Ground
• pletion, the owner will have the burden of proving he/she did not build or Im- SUMMARY OF FEES
rove for,the purposeof,sale). • Duct-Structural System Repair/Alteration BUILDING PERMIT 5� SMTP , t $ ' •
•- U I,as owner of the property, am exclusively contracting,with licensed con •-
tractorsto construct the project(Section 7044,Business-and Professions-Code: Duct--Ventilating } - - PLAN CHECK $ PERMIT t
The Contractor's License Law does not apply to an owner of property who • , - ISSUANCE $
builds or Improves thereon, and who contracts for such projects with a con- - ' Exhaust'System ❑ Multiple❑ PLUMBING $'
tractor(s) license pursuant to the Contractor's License Law). •
, GRADING ' $ I
❑ I am exempt under Section B.& P.C.for this reason 1 Firepl/Fact.Bit.ICB0#3195 • -4 00 PLAN CHECK' $ - '
. - - ELECTRICAL - $ $
•Date Owner' - ' Heating System&Ducting , , MICROFILM $
I hereby certify that 'Ithave read t is application and state-that the above- ' 00-100,000 BTU 0100,000 BTL - PLAN CHECK ' $• .
Information Is correct. I agree to co ply with all city and county ordinances - i 0 TOTA LFEE $
and-State laws relatin to la Biding ••nstruction,'and hereby authorize repro- • Hood or Type I ❑. MECHANICAL $ 7 7. 00 •
,sentatives of;[ c t• • to u•on the above-mentioned property for y0- Reinspection'Fee $15 ' LESS -
inspection rp s. Canopy Type I I 0 - PLAN CHECK' $, 2'. 00 i
Signature • v/ Date a/1,6/83 - I t • ADVANCED PC $ •
' •Drivers' ucen or S # .: Registers • Issue Fee $ 3
_ - _ ' FINAL FEE $ ' 9_00
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor '
CONSTRUCTION AND PLANNING POOL 'A
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 r.
7. Footings 58. Electrical Conduit-Undrornrl. •
8. Foundation •
59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System e7 - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
u 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final •
15. Rough Electrical-Conduit 66. Solar System-Final
16: Rough Electric Wiring 67. Fencing& Access Approval
17. Rough Wiring Sign •
68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace. j1Jy/y1,g/PC APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
,23. Gas Pipe-Rough &Test 72. Underground Flush
24. Roof'Framing 73. Undergrnd.Storage Tank 0 Gas 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 Notes:
31. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace ,�!/�{0//w „�jD
38. Final Plumbing �l
39. Water Service-Final
40. Gas Service-Final
' 41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE& BUILDING
48. Special Requirements Completed
•
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERM T NO CT O. LOT NO BLDG.NO. _ ��/,l
CONSTRUCTION PERMIT i 9� �� ��t�7�02 `77 I U'"
� � et,
Aut ��s 7243 (0/I';/�_ IL
applicant's Mailing Address++��//�1 �]^Q(�q l,, TYPE OF CONSTRUCTION laNEW U ADD U ALTERATION REPAIR -
Project Address ✓y11/)��,1q/nt1 �I"-J` btu- B 6/7/-3q76
yJ-�L El CONVERSION 0 DEMI H- OTHER a
Owner's Name 9760 "-kV]
r Ia, �))G��gyyj��',,,(((�(/y,yy Phone/-'/7/-3 I76 DESCRIPTION OF WORK l /`"�'\'y"J�11 ZONING REGULATIONS •
Address 97 O r' / /" " 1 Scale, /� "` ' TYPE OF PERMIT U GRADING ❑ FOUNDATION Li STRUCTURAL A.P.# ZONE -
Arch/Eng. J License No. C TENANT 0 ELECTRICAL 0 PLUMBING MECHANICAL PLNG. REF.#- BUILDING
Address 0 OTHER TO BUILDING ecru^CV Cl' or
' PROPERTY LINE REAR YARD(TO P/L)
a
Contractor's Nam: /-.L .if '/i al. • 4. •119ne 6-7-4440 PROJECT DESCRIPTION SQ.FT. OCCUPAN xi5
S6 • CONSTRUCTION TVPF VALUATION$ 1i LEFT SIDE YARD RIGHT SIDE YARD
Address(mailing) /0�v ,s� 1N(14�1 SCLN-Q' 4-
License No. __
DIr'J?Y t/ • ZONE GRADING CU.YDS. ACRFS PKC.SPACE REO. PROVIDED
LICENSED CONTRACTOR DECLARATION • Remarks: /-!,_75!/y STREET WIDTH _ PARK FEE$ -
I-hereby affirm that I am licensed under provisions of Charter 9(commencing 7 7
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS: -
my license is In fuu�jljl force and effect. - • - - ,
Ucense CI ¢�� �y. nk• �� ��� • PLUMBING •
Date bTG�J Signature
WORKERS'COMPENSATION DELLA RAT .t Bar Sink Sewer Cap I ELECTRICAL
'oreby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Sewer Connection Automatic Washer •Meter Dover 100 amps
Workers' Compensation Insurance, or a certifie copy thereof (Section Construction Pole
JO, Lab. C - "- Sub Panel
un�0• 176g Company / Backflow Irrigation Solar Collectors •
Policy No. t' - - _" Cooking Unit Sub Pole
Certified-copy is hereby furnished. ' Bathtubs Solar Piping
•
Cerllttietl'`cql)t.,Is filed with the city Bu Ing DJvission. 5 Dishwasher Motors ❑0.1 HP ❑1`h-8
cess a /0 4 7 Applicant jf /y).R � Clarifiers Solar Tank
EXEMPTION FROM WORKERS'COMPENSATION e ECLARATIONDryers ❑Gas ❑Electric Inc.Solar 09-15 HP 016-15+
(This section need not be completed if the permit is for one hundred ($100)or Dishwasher ,'✓ Swimming Pool w/Spa _
less). Fan Microwave
I certify'that in the performance of the work for which this permit is issued I Drinking Fountains Urinal '
shall not employ any person in any manner so as to become subject.to the / - F.A.U. Pole Light '
Workers' Compensation Laws of California. Floor Drains . Water Closet_ •
Date • Signature - Fixtures
NOTICE:If,after making this declaration;you should become subject to the ' ' Floor Sinks , Water Heater _ Range - - -
Workers' Compensation provisions of the Labor Code, you must forthwith •Device Boxes
comply 'with such provisions or this' permit shall be deemed revoked. Gas Service Outlets - Water Service Sign
CONSTRUCTION LENDING AGENCY Outlets
I hereby affirm that there Is a construction lending agency for the performance Interceptors - - Standing Sections ,
of the work for . I this permit Is Issued (Section 3097 Civ. C:) Switches
Lender's Name Jl/ Q/ Kitchen•Sink _ - • Trash Compactor
Lender's Address
OWNER BUILDER DECLARATION - Lavatories . . - i •
Garbage Disposal
I hereby affirm that I am'exempt from the Contractor's License Law for the P-Trap - Generator 00.5 KW 05-15 KW '
following reason (Section 7031.5 Business and Professional Code: Any city or -
county whichrequires a permit to construct,alter,Improve,demolish or repair - - • Transformer ❑15.50 KW
any structure, prior to Its Issuance, also requires te applicant for such permit Roof Drains -
•
to file a signed statement that he/she Is licensed pursuant to the provisions of ❑5U+KW
the Contractor's License Law(Chapter 9(commencing with Section 7000)of - -: - • Reinspeetion Fee $15
gyofolon•3 of the Business and Professions Code)'or that he/she-Is exempt Showers - - . • - Reinspection Fee $15 - -
.p,Arom and the.basis for the alleged exemption. Any.,violationof Section Meter ❑up to 100 amps •Issue Fee. '$ 3
•*5 by any applicant for a permit subjects the applicant to a civil _
tit 'ay of not more than five hundred dollars($500). ! . , Service Sink Issue Fee . $ 3 Zoning Approved By Date
. LJ I, as owner of the.property or my employees with wages as their sole - - - -
compensation will do the work, and the structure is not intended or offered • MECHANICAL Application Approved By nate
for sale (Section 7044, Business and Professional Code: The Contractor's ' -
License Law does not apply to an owner of a property who builds or Improves , • Boiler ' Refrigeration System Application Issued By -/ A / A0-/3-cP3
' thereon,'and who does'such work himself/herself or through his or her own PP -Date
employees, provided that such Improvements are'not Intended or offered for ' i Duct-Under Ground ❑0-100,000 BTU ❑100,000 BTU
sale. If, however, the building or Improvement Is sold within one year of com- SUMMARY OF FEES • '
pletion, the owner will have the burden of proving he/she did not build or Im- `
rove for the purpose of sale). ' Duct-Structural System Repair/Alteration BUILDING PERMIT $ SMIP ' $
I, as owner of the property, am exclusively contracting'withillcensed con-
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ' -- _ , ._ _ -- PLAN CHECK $ PERMIT •
• The Contractor's License Law does not apply to an owner of property who ISSUANCE •I $
I builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 'PLUMBING $
tractor(s) license pursuant to the Contractor's License Law). • I •
'PLAN CHECK $ GRADING $
' ❑ I am exempt under Section •
B.& P.C.for this reason Firepl/Fact.Bit. ICBG./k I i $ '
ELECTRICAL $
Date Owner' Heating System& Ducting ' - - MICROFILM $ '
I hereby certify'that-I have read this-application and state that the above- k0-100,0008TU ❑100,0008TV- -- - ; - T/it, 00 PLAN CHECK. $ -qg�—
information is correct. I agree to comply with all city and county ordinances I 1 ! •
/-" TOTAL FEE' ' $
and state laws relating to building construction, and hereby authorize reDre- MECHANICAL $ --�—r'"p— 1
sentatives of this city to enter on the above-mentioned property for Hood or Type I 0 Reinspection Fee $15 PLAN CHECK' LESS
inspection purposes./)�_y/y / Canopy Type II 0. - $
�'CJ�O / i /10-L� ADVANCED PC $
Signature , Date -
Drivers' License or SS# Registers Issue Fee $ 3 FINAL FEE• S
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor •
Y •
Q nCG^NSTRUC,TION-ANDSPLANNING •, c ? .S . • '. •• . - - POOL-P -''A _ - -
Date - Inspector . Date :Inspector
APPROVALS , Permrt# r _ - 'APPROVALS- Perri...#
. ',I Temporary,Electrical ServiceorrPole _ - - ' . 52:Pool & Equipment Location :j . " - _
i 21 Soil Pipe-Undrgrnd' ...:'. .--37, ° `_ , ° .1€-. 1 _ 53. Steel Reinforcement
~: 3:• Electrical Conduit Utility-Undrgrnd. _ ; _ 3 54.1 Forms : '
4: Electrical Conduit-Undrgrnd'. , ; ; r, :3:!. - - 55. Electrical Bonding _
53; Steel Reinforcement ^ `" ' "'- • _. t a. . ; 56•, -Rough Plumbing&Pressure Test -
'
6. Electrical ie - 57':-APPROVAL TOCOVER-GUNITE
..i i r, - -;-
7. Footings 'o t. ' .; c r^ •r 58. Electrical,Conduit-Undrarnd. -
8. Foundation l ' :1 , - '::. ; 59. Gas Pipe Undrgrnd-,Test ,.
•
9. Water Pipe-Undrgrnd. , _ - ' 60. Backwash Lines,P-Trap, O Undrgrnd.
10. Structural Floor SyOni (F i 61. APPROVAL TO DECK
11. Property Sewer Line&House Connection r _` 'X62. Backwash & Receptor-Final ..-
12.
12. Sewer Cap - 3� - ' - ? ' 63. Heater& Vent-Final ' - -
., I ,� i -
13. roof;Drain? , , c - •�, 64. Plumbing System-- Final - . �, -
< 14. Rough Plumbing . -"65. Electrical-Final - -
o ' 15.trough Electrical=CohdLit-I ":j-' -, T'--; -?-' - t- -667Solar System-Final ,
a.46. .Rough_Elec[ric Wiring I 'I :I„ : C•,7' --- - -67. Fencing &:Access Approval' . - : i _ .3..',:-. - • ' -
k 17. IRdugh•nWiriiig"Signe P I I'.' 13-1 68. APPROVED FOR.PLASTERING _ •
✓ 18. Rough:--Electrical=T;Bair Ceiling 41I • I ( ' : ' ' 69.: POOL/SPA SYSTEMS FINAL -- •
,r 19. 1Roug &
h,Heating 'Air Conditioning ' 4,//n �O FIRE DEPT.REQUIREMENT.
• ` 20. ,RI
ough Factory Firplace' j , ; p II I I , I I I APPROVALS! ,PeI rmit'# - `-
21. rD'ucts,.in Structure i '" : I� i, I ' l I , 70. Underground Hydro }
` ',:?2. (Ducts;Ventilating ',_ I it I : , ' 71: Product Piping O Gas ❑Oil
;
23. Gas Pie-Rou h& Test Fr ' -T--_ 1 _ _
P 9, i ( " r I�' I I_ � I : 72.IUnderground Flush
-24• 'Roof Framing ' � 3; I `- - _ I", I,y ,. 73. Undergrnd.Storage Tank 0 Gas 0 Oil. i
F 25. Roof Sheathing I I • ' I .a I. .' 1 j n I_-• , ' j 74. Overhead Hydro ' ,
J ;26. T-Bar Ceiling (Structural),& Monocoat ' ° I , ' :1 I -; 75J Dry Chemical
r2). Frame and Flashing: _ j , , I 1 I i j 1 I 76. Dry Standpipe
'I28. 1j':Lithing &-SidingI n o I II II I 1 I I I 77.' FIXED SYSTEM.FINAL
c
d 29. ),Insulation - ' I R '-, 3 .i ; I i 1 •I I 78: FIRE PREY. FINAL 1 •
:.-::30. Drywall Nailing >ti i' I : 11 I' I • ' ' ,Notes: •
31. :Plaster Brown Coat I, 3, ' i Ij 'I -� I• _--
4-32.rElectrical'Power Meter-Final I If I I j -
1 33.rFinatEll tric I l.. ' LIi acs ! _L.a_,.IL .�I ' I •
..
`= 34. Final Heating & Au'Conditioning , �' /�,•' i r I I '
35. Final GaslPipe=Testt. I-• : in' I -I 'I !` I•' 1' I - j ' lal I,•. ' I '• , • - -
36. Hood or Canopyrt,4 :I:n I t I ,' I I 1 - 1 1 - ' , - - _
37. Final Fac•tory Fi eplace,- , : I r1 I° I. = :I - - •, •
38. Final I,Ilumbng 11 I I I? h I • i I ., ' 11 . _ .
39. Water Service-Final, , ; ' . I j
40. Gas Sej-vice-Final I j I I1 ry i I ! I ' I , I 1 i i • -
41. Solar omestic-Final I ! ' 1 ' ' '
42. Backfloty{Preveriterl -3-I I I ; ; : 1 --'-_ --. _._ ! 1
43. Backflow Irrigation! a � " ' I • -•
44. Landscape IrrigattonrSYtem 'It - _ - ""
45. Sound„"Attenuation '1 � t I I it I r I I�` , " _ ' ( ,
46• Handic p�Regulations I I R I - 1 '` I "r
c •
47. FINA1�'STRUCTURE & BUILDING u I'. I j:. -,,I ; i I
48. SPecial Require rents Con plated j I I I Ii I I '
`
49. Electric Rt
elease Io Edison I ° i I. _ i ;
50. Gas Release to Southern California Gas Co I I I ; I I ; , ' ! ; .
51.,CERTtFICATEOFI000UPANCY II ; - •J-.� '
No, I ' ; Date i 1 *ji I 3, , ,