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Home My WebLink About944 VICTORIA ST - Building PermitsPR0.1ECf�DURF83: j44 VICTORIA ST OWNEfl'SNIIME: CITY OF COSTA MESA �oonEss: �� FAIR DR, C.M. ��%1 pACN1ENGIXEEIII' �OOflES3: n�o.xo.: uxrt: UNR: PE"r"mEE:pROJECT ADMINISTRATION (714)754-5029 eoouss: 77 FAIR DR C.M. CA 92626 UCENSED CONfMCTOR OECUMTION: I �ea�y atfirm itut I am ficense0 unOtr provBiom ol Clupter 9(commencin0 ��h Section 7000) ol Divlsion 3 0l tM Business an0 Pralessions COEe, antl my Gceme ¢ in IUA force anE ettect. CITV 11C.: STQE UC.: C1A38: Da�e: Siqnature: WOBNERS' COMPEN311TION OECIAMTION: I hereGy affirm that I lave a ceNArata ol cansent to ull-Insum or a ceN/lcate ol Workers' Compenution Insurance, ar a mrcilietl coOY ��ereol (Seclion 3800. LaO. C). POLICY NO.: F%P. O�TE: COMPRNY: � CertllieE copY is hea6y tumisAeO. ❑ Certitied capy is fletl wit� Ne city BuilGinp D'Msian. _�. �ate: ApDlicant: IXEMPIION FPOIA WOHKFAS' COMPENSITION OEGAIW710N: (iFa seclian nx0 not Ee competed'A Ihe panil6 M are AuMrtE (f700� a kss). I cenity Inat in e pEAortnance of t�e work tar wtnc� Nis pemut B issue0, I shatl not empby azry persan In am/ manner so az to 6ewme suUject to the,�orke q�s/atio�n LaxS oi Catitmtia. �� . Data: 'S /SL— �O�tum: � l � � NOTICE: I altu maYJnp Itds Eedaatim. you sMWE hxome siAIK� lo tlre Workers Compeisatioo provWms ol tha lahor COEe. yau°musl tonMrith campry wiN wtA Drm�isiois or Ih¢ perrtrit 5hall Ee UKnceE rewke0. CONSTBUCTION'IFNOING ►GENCY: I �ereby alfum Nat Nero k a mmiruction ImONq apenry Iw Ne pertarmance ol Na xrork tar wNCh [Als Derinit:ls IsweA ISectbn 3W7. Civ. C). OWNEB BORDEP DECIAIWTION: t Aere�y aifirm ttat I am exempt tmm IDa Contactors' SWte Lke�e Law lor the tollawinp aason (Section 7091.5 Business aM Professbnal COEe: My dry ot counry whiG� repuires a pemrit ro crosinn1. atter. improve, damWlsA. or reDair airy SUucWre. prim to fls isswirce, aho repuires the apqic�nt lor wU pemtit ro lile � dpne0 statemmt ttut �Nstre Is IlunseC pursuant lo tlre provisians ol IM Cantnetors State Liceme Lrx (CMpror 9(mmmentinp wIN Sactlon 7W0) ol OiWsion 3 0l t�e Business an0 Prolessians Code) or ttut he/slro is axempt ttreahom a�M ttre Eavs lor Ne aAepeE uemptbn. My vbWqon ol Sectlon 7031.5 Ey anY aP7lkant lor a D� �I�ts Ne applkant to a dM penalry al mt more ttun iNe huMraE OWlars (55001. I, az awner ol Ne vrapeny or my emp loyees xitn wapes az UUr sole mmpansaqon, wiu ao tha waM, ana tna ❑ simcWre Is nat intenGeE or offereO lor sale (Section 70dd, Business anE Pmlessional CaOe: T�e Contracrors' State License Law does not apDly to an owner ol a D�operty wlio DuilQs or improves t�ereon, an0 w0o does suc� woIX Mmsell/�erself or thmup� his or Aer awn employees, O��4e0 t�at suc� ImD�'ements are not intenEeO or olleroa lar sale. II, howavar t�e bulltlinp ar impmvement is so10 wilMn ona year of complelion, tAe owner xill have t�e DUNan of OmdnO �USAe OiU not OullO or ImOrove , lor I�0 Dufpose ol ule). 1, u owner oi Uro Droperty, am exdusively cantraclinp wRh ticenseE contractors ro construcl IM D�dect ISectkn 70C1, Business '� anE Prolex4ons CaEe: The CanVacton' SUro Lkmse law tices wt appty to an wmer al properry wM Dull05 w Impraves tAereon an0 wno cantrac6 far suU D�ajecb wIN a wntrattor(5) liunsa Oursuant to Ne Coniractors' State License Law�. I am aware Inac pwol al t�eir worker's Compensation insuranca SMuIA Ee proviAeE to me. � � I am exempt under Sectlon: 8. E P. C. for Ihis reason: O �T .��iG� Daro; � `� I tlo �ereEy arti Nal I a awue of mO unGerstaM Ne repwemenis ol Califomla HWth �n0 Safery CaEe Sections 25505. 25533, anC 25534 an0 tAal I or any future WJIOInp acupant wiMxitl not (�tle ane) nee0la wmpy with 5ai0 state wOo anOlhe reauirements lor a permit lor canstrucibn or nmtlilinlion Irom th�ii ry Ma�uqertcent Oishice Ne90enUa1 wnstrucGon applinlions ara exempt Irom �Ilue 7roviSlonS. Dare: ApplwanL i �ereEy ceniry tnat I nare reaE �Ire appiintion um stata tAat Ne a6ove iniomution "s mrtect. I apree m wmpty wrtn atl ciry aiM orOinarKes aM state Wws reWtlnp lo DuOGinp camvucYan aN �ereGy aWn� representaWa o1 tlus dty ro etrter upon Uie aEovo-me properry for inspectun Durposes. � /�—� Date: ��_/ Si78�c �-7•��=----T!•/.�� Dmrer's �icense r Soda� ecuriry M: 18a1de Whito—BuilEiep: GreerCoEa Enloreertrent: Canary—Applieant: Pink—Revenue: Gobanro0—Asaoawr �� CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 047311 PERMIT NO: E 047311 PLAN CHECK N0: N GOVT: Y SUPP: N CONSTRUCTION TYPE; PERMIT TYPE: ELE PORPOSE: OTH JOB DESCRIPTION ; ELCT HOOK—UP SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: / COMMENTS: ***�x***�r�r**�r*��r+r*�*x�*��***�e*x�****�e�*�***�**+�*�rx*�x��*�*�r�**xx*�*�**+�**�r+r�*�* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUZLDING ---------- --------- ACCESSORY BUILDING,--------- FRNT: FT IN REAR: FT IN FANT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42243326 ZNE: REF NO: PLANNINC NdTES> > ' iE �f iE if if iE iE iE it it iF If if iklE if 1f 1f it if il� iElElf if it if iE iE jf jE 7E ik iE iE if iE it iFlE if iE k 1FlE ik M iElk iE �E if it ik iF M iE 3E iF!! it iE 3E 3f �E iF iF iE iE iF iE ik if iE it iE iE iE iE D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY : DATE: APPLICATZON ISSUED BY: �SY�— DATE: ��0 it it if 1k if �t iklE ih k iElE ih if it it iF it ih 1f iE 1f iFif��3F�FiFi�iF3F'iFiF�iF7F3FiFit'{f"iF'iFiFii"ifiF�iFif if iF M it if ak iF k if ik ia jt iF iE iE if if it iE �f iE 1E 1F iE iP ik �k HE it if iE it iF M iF iF it 3E jF iF iE iE iE iE k iF iE iE iE iF iE iF it if ik 1E ik if if if M iE 1F df iE 1E k if if 1f iE if i! iE if 1F if iF if iF if if it k iF iE if iE if it LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMHING ELECTRZC MECHANZC FIRE SMIP/RES GRADING PERMIT 18.50 502 SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECIC TOTAL PAZD DUE TOTALS----> 0.00 0.00 0.00 0.00 .00 .00 REVENUE DIVISION TOTALS--> COLLECTED: .00 OVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 1E ik it if iklf iF �Elf ik iE if iE it i! if if iF 1! i! 1E ik if ik if k if if ff iE 1E iE iE M iE iE 7ElE ik if iE 1E iE iE 1t i! it 1! ik k iF if jk if if if it ik iE if iE ik if if iF if if iE iF if iF iF iE it iF �F it M ik Z N D I V I D U A L F E E B R E A IC D O W N TYPE (jTY D E S C R I P T I O N UNIT COST TOTAL COST �LE 1 SERVICES HELOW 600 V& BELOW 201 AMP 18.50 18.50 END OF FEES 01 000608S3—OO�b�853 � r� T OATE: OS/15l40 TIME: 10:55 .00 - CONSTRUCTION ANDPLANNING POOL PA APPROVALS Permit # Date Inspector AppqOVALS Permit # Date Inspector i. Temporary Electrical Service or Pole s�s 52. Pooi & Equipment Location , 2. Soil Pipe�Undrgrnd. 53. Sceel Reinforcement -- ; 3. Ele cal Conduit lltility-Undrgrnd. 54. Forms � 4. Elec[rical 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, O Undrqrnd., Test 9. Water Pipe�Undrgmd. � 60. Backwash Lines, P•Trap, O Undrgrnd. ��.� 10. Structural Floo� SYstem 61. APPROVAL TO DECK �' �� ♦ 11. Property Sewe� Line & House Connection 62. Backwash & Receptor-Final ;� 12. Sewer Cap 63. Heater & Vent•Final � � 13. Roof Orains � 64. Plumbing System � Final � � 14. Rough Plumbing 65. Electrical-Final � � 15. Rough Electrical-Conduit . 66. Solar System-Final ' 16. Rough Electric W�ring � 67. Fencing & Accese ApProval , �• 17. Rough Wiring Sign ' 68. APPROVED FOR P�ASTERING �' 18. Rough Electricel�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning , FIRE DEPT. RE�UIREMENT 1 20. Rough Factory Fireplace ' , APPROVALS . Permit # 21. Ducts, in Structure �' 70. Underground Hydro 22. Ducts, Ventilating .71. Product Piping OGas OOiI 23. Gas Pipe-Rough & Test � 72. Underground Flush 24. Roof Framing ' 73. Undergrnd. Storage Tank O Gas ❑ Oil � 25. Roof Sheathing 74. Overhead Hydro � 26. T�Bar Ceiling (5tructural) & Monocoat 75. Dry Chemicai 27. Frame and Flashing 76. Dry Standpipe _ 28. Lathing & Siding � � . � 77. FIXED SYSTEM FINAL 29. Insulation • � 78.,FIRE PREV. FINAL 30. Drywall Nai�ing HEALTH DEPT. REQUIREMENT 31. Plaster 8rown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final ElecVic Noter. � � 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 pomestirFinal . 42. Backflow Preventer ' ' . 43. Backflow Irrigation 44. Landscape Irriqation 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 AVOlicant to fill in all spaees except t�osa within heavy DOrGa� Iinas an0 slgn all a00�opriata tlecla�ations. CITY OF COSTA nn�A, CONST U TION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. Project Address �� . Applicant's Nlailin A dress Owner's Name hona Address Arch/Eng. License No. Address Contractor'sNum � �Phone� Address (mA �'��1 ��O �OL��2 W �'f . ��ff City License No. � Z7� LICENSED CONTRACTOR DECLARATION I h¢reby a/tl�m Ihal I am licensetl untler prOvisiOnS of GM1a�ta� 9(commantln9 wlth sectlon 7000) o/ Divlilon 3 ot the Buslness antl Profezslons Cotle, antl my license Is in tull fo�e�ntl efie t. /� ,�/� �iren CI a / Lk 5 No T� oai� •`�—1 t s's'� �� I��"�`d� \� WORKERS' COMPENSATION DECLARATION � ' hereby aftirm that I have a certltiwte of consent to self-Insure ar a certlficate \ Workers' Com0en5ation Insurance, or a certifietl Copy thereof (Sectlon J0, Lab. C.) (_ 1 7olicY No�-y� 6�� ComPanY ��^ S � Certitietl copy Is �ereby furnishetl. Daleertiji=gcoP`6�i�"It0 wAPPI{cantY B�yWin9 �1(�SIOn. S "O "� / � Ol E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectlon neetl nol be completed it the permit I5 for one huntlretl (E700) or less). I certiy that in tbe pertormance oi tne work tar whith thls perm�t is issuetl I snall not employ any person in any manner so as to Docome subject to t�te Workers' Compensatlon Laws of Calilornia. �ate Slgnature NOTICE: H, atter making this tleclaration, you snoula become subject to the Workers' Compensatlon proWzions o( the Labor Cotle, you must forthwith comply wlth such provisions or Ihis permit snall be tleamotl revoketl. CONSTRUCTION LENDING AGENCV I hereby aHlrm that thare Is a mnstruttion IenCin9 a9ency for Ihe performance of tha work for which tbi5 permit is issuetl (SeCtlon 3097 Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUILDER DECIARATION I M1erebv aHlrm Lhat I am exOmpt trom tbe Contracto�'s lltlnse I..aw 10/ [he 1\ utlure, prlor to its issuance, also reqWres tne apP��ant �or sucn parmn a Signatl SIdtCTQnt that he/ihe i5 II[en5¢tl purSUant t0 th0 ProvlSiOns of ,..� ....•� i tr��.. i a�., rcnanre• 9 �commencina wilh Sectlon 7000) of �erelrom anG the basvs tor tne aue9ea exempuon, sany v�v�auo�� 31.5 by any aoo��cant for d petmlt SUDjects the appllcant to a Clvil enally ol not mora than /lvo huntlretl tlollars (5500). I, as owner nl thu propurty or my employees wltn wage5 as Ihdr Solo compensalion, wlll tlo tne work, antl the itructura is not IntenOetl or oHaratl for sala (Seclion 7044, Business antl Profei5ional Cotle: Tho Contractor'i �icense law Ooos no[ apply to an owner of a praperty who builEs or improves tharaon, antl who tloes such work nimseli/herseli or throu9h his or hor own employaes, proviactl tnat such ImDrovements are mt Intentla0 or otteretl for sale. II, however, the euiltling or improvement Is soltl witnin one year of com- platlon, the Ownar wlll hdv0 Ihe burtlen of Ptoving he/Sno tlitl nol bulltl or Im- prove tor the purpose ol saie). ❑ I, as owner ol the DroPerty, am exclusively contraclin9 wltn Ilcensetl con- tractors to construct lhe Oroject (Section 7044, Buslnest antl Prolassions Cotle: The Contractor's Liconse Ldw doe5 not aDPly to dn owner oi Oroperty who builas or Imoroves thereon. antl who mntracts br such oroiects wlth a r.on- tractor(s) Lcense pursuam to [ne ConVactor•5 License Law�. i am aware [ha[ prool of tnelr Worker's Compensstlon insurance ihoultl be provitlatl to me. ❑ I am exempt untler Section B. 6 P. C. for thls reason Date Owner I �erGDy certlfy that 1 havG r¢d� Iniormation is correct. I agree to an0 state laws relating to builGin sentativas of thl ity to ter inspection purpo 5. Signature Orivers' license or 55 $ ] state that t�e above antl countY orainan<es �erGby authOrize repre- mtlonetl Oiooerty or Dat � l� 6 �o v TVPE OF CONSTRUCTI.O91 NEW ADD ALTERATION ❑ CONVERSION � DEMOLISH ❑ OTH R � DESLRIPTION QF WORKfUSE QF BLDG� �"+�� ew�"'� TVPE OF PERMIT LJ GRADING LJ FOUNDATION U STiiDCTU �❑} TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANIGAL LJY�OTHER D��w.�0 ��'�"t��^ PROJECT DESCRIPTION SO.FT OCCUaANC� ` CONSTRUCTIONTVPF VALUATION$� ZONE GRADINGCU.VDS . ACR�_ Remarks: Sink Preventer Irrigation Drinking Fountains Floor DrainS Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Hoot Drains Reinspaction Fee � $15 Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. BIL iCBO dk Hea[ing System & Ducting ❑ P7 00,000 BTU � 100,000 Reinspectian Fee � 515 0865-46, rev. 5/BB White - Builtling; Canary - Applitant; Pink - Accounting: Goltlenrotl - Assassor Showers Service Sink Sewer Cap Sewer Connection Solar CollectOrs Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Clout Wacer Hea2er Weter Service Auto-Wash laue Fee Hood or Typel ❑ Canopy Type II ❑ iefrigeratiOn System afi-�oo,000eru ❑too,000 System Repair/Alteration Fire Dampers Registers laue Fee A.P. 3W W S Main Buildi REPAIR E T Fron[ B Rear �A C Right K Left � S' Ping. Ref. # Planning Notes: FEES 'lutomatic Washer Construction Pole Sub. Cookin9 Unit Dishwasher Dryers �Gas ❑Electric Fan F.A,U. Fixtures Device Baxes Outlet5 $witche5 V. Garbage Disposal � Generator O65 KW �5-' m Fee Zone Accessory Building: Parking Req./Provided ELECTRICAL Trenstormer ❑ 75-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over t00amps � Sub Panel • Motors 00.1 HP �1'h � 8 Inc.Solar 09-75 HP O1E15+ 'Mittowave •• Pole Light • Range Sign � Standing Sections 5 KW Trash Compacror 515 laue Fee $ 3 �_ DEVELOPMENTSERVICESREQUIREMENTS: 2oning Approved By FEES 'Buildine APP�oved By Appliwtion laued By S 3 BUILDING PERMIT $ , a PLAN CHECK $ PLUMBING $ . �PLAN CHECK 25% $ , ELECTRICAL $ ' � PLAN CHECK 50% $ � MECHANICAL $ PLAN CHECK 25% $ N I N G R E � M T S. FEES 5 3 St11NNflCRV OF FE�S V � - IP_ � � �� $ ENE G C.� GRA I MIC FILM TOTAL F Ol �002749Q—;,002749C YCeT .00 DATE: 03/Q2I89 TIfiE: 14:_0 �. t�.t\ t� _ . _ '� CONSTRUCTION AND PLANNING P�� P'4 � �APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector r . . � 1. Tem orar Electrical Service or Pole � P Y 52. Pool & Equipment Location 2. Soil Pipe-Undrgmd. �, _ ' S3. �Steel Reinforcement -' 3. Electrical Condult Utility-Undrgrntl. -' , 54. Forms 4.'Electncal Conduit-Undrgrnd. 55. Electrical Bonding 5-. Steel Reinforcement � � -� 56. Rough Plumbing & Pressure Test i .6. ElectricalUFER'Grnd.' 57. APPROVALTOCOVER•GUNITE � -7. �Footings . , � � ? � 56. Electrical Conduit-Undrgrnd. � 8: Foundation " � 59. Gas Pipe, � Undrgrnd., Test 9. Water�Pipe-Undrgrrid. -�- �.� 60. Backwash Lines, P-Trap, O Undrgrnd. 10�.-5[rucfural Floor System � 61. APPROVAL TO DECK 11. Property Sewer.Line & House Conriection " � 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 �. __ A9. Rough Heating & Air Contlitioning FIRE DEPT. REQUIREMENT .i 20. Rough Factory Fireplace �'' APPROVALS Permit # 21. DuCts, in'Structure ;� 70. Underground Hydro 22. Ducts,.Ventilating '„ � 71. Product Piping [7Gas ❑Oil 23. Gas Pipe-Rough & Test „. 72: Underground Flush � 24. RoofF�aming � - - 73. Undergrnd.StorageTankQGas ❑Oil � 25. Roof Sheathin9_ , � , . 74. Overhead Hydro 26. T-BarGeiling (Structural) &�Monocoat 75. Dry Chemical 27. Frame,and Flashing -- 76. Dry Standpipe 28. Lathing�& Siding 77. FIXED SYSTEM FINAL 29. Insulaiion 78. FIRE PREV. FINAL 30. Drywall��Nailing � . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' � 79. FINAL INSPECTION 32. Electrical power Meter-Final. �80. FO00 CERTIFICATE ISSUED 33. Final Electric __ "� Notes: -r N 34. Final Heating & Air Conditioning � C, ✓� a, P o 35. Final Gas Pipe�Test LoNG ' 36. Hood or Canopy 37. Final Fac[ory Fireplace �%'f� G�}. �L ¢/� 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final `�_� 41. Solar pomestio-Final ,�, � � ' � } 42. Backflow Preventer ' ' `r I � � , . 43. Backflow Irrigation ' _ . _ /�, . � i r 44. Landscape Irrigation System . � - /, 45. Sound Attenuation �' � ' � -�. • 46. Handicap Regulations � � = i ' - � 47. FINAL STRUCTURE & BUILDING o 7 ' '• �; � r � 48. Special Requirements Completed � �.',�� / %� �� 49. Electric Release to Edison �-, � ��o ��, 50. Gas Release to Southern CaliforniaGasCo � � �� 51. CERTIFICATE OF OCCUPANCY r� I�� ' •� No Date " AOP��eant to fill in al1 spaces exeeot tnosa within neavy GorEer Ilnas antl s19� all avproDriate tleclaratlons. Ci7v pF GOSTA /E/S�p/ CONSTp�(UCTION PERMIT ' Project Address �YY U � G�tO �I /� �4PP�fCant's Mafli�n[9 Addre s �� ,/ Owner's Name "A"� p'�Z Phone SLZ 7C%r Addreys 'SAr�'C"' _ Arch/Eny. .- LicenseNo. . Addre,s ' �^ ' � . Contractor's Name� `�OYY�+e- Phone 37 /7/3 _ Addreulmailing) �57� �C.�.n�fSi City License No. �%�D� � , LICErySED CONTRACTOR DECLARATION � t hereby'allirm that 1 am Iicensetl untler provisions of Charter 9(commencing wit� 5¢�tion 7000) of Divisfon 3 0( the BuSiness antl Profezsfons Cotle, antl my ncense Is in fwLtorcg eirect. � �D %S/O � License Class Y icense No. Da�e �'"��-T Si9natu�e WORKERS'COMPENSATION DEC4ARATION � ' hereby affirm that I have a certlticate of consent to self-Insure or a cerUficate R Workers'. Compansation Insurance, or a certifietl'topY thereoi (Settion 3800, �b.¢�y� �+ c ,/ • ' y� — 1 ' Po,�i�cy NOJ'�C� 7SD�Y� Company N�F/�A yJ Certi(ietl copy is h¢reby furNshetl. ' . LJ Certifietl copy is f"I tl with the city B il i si n. �Date �—� fJ� Applicant � ��d - .EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � (Thiiseclion nee� no[ be completetl if the pe�mit i5 fo� One huntl�etl (E300) o� lest). I certify �that �in lhe perfo�mance of th¢ wo�k fo� which [his pe�m�t is i55ueQ I shall not employ any person In any manner so as to becoma subject to the WortCrs' Compensation Laws ot California. • , Date - Si9nature NOTI�E: If, a�ter inaking this tleclaratlon, you shoultl become subject to the Workers' Compensation provisions of the Labor Code, you must.fort�with comply wi[h such provisions or thls permit.shall be�tleemetl revoketl_ � COftSTRUCTION LENDING AGENCV. I noraby afBrm that there is a constructlon lending agency for tho performance of lha work for which this permlt is issuetl (Sectlon 3097 Civ. C.) Lentler's Name � - Lentler'z Adtlress OWNEF BUILDER DECLARATION � ' ' � - 1 nergby afilrm that I am exempt irom the Contracfor's License �aw for tne folloWing reazon (Section 7031.5 B�slness antl Professional COGe: �Any city or mun[y whiGh repuirGs a Oermlt lo cOnStruct, dlfe�, imprOVG,'tlemolish o� �¢pait any structure, Orior to its issuance, also requlres the applicant for such permit t0 filp a Slqnetl stat¢menl�[hat he/She Is Ilcensetl pUrsuant fo the provisions o! • the Contractor'S License Law (Chapler 9-(commentlng with Section ]000) of Division 3 ot the Business antl Prolessions Cotle) or [hat he/she is exempt thereirom antl the ba5is for the allaqetl exemption. Any violalion ot Seclion �7031,5 by any applicant for a permit subjects Ihe applicant to a civil �enalty of not more than five huntlretl tlollars (E500). �, as owner of the property o� my employe¢s wlth wages as their sole rompensatlon, will Oo the work, antl Ibe struGture Is oot Intentl¢tl or oftetetl tor sale (Section ]044, Business antl Pmfessional Cotle: The Contractor's Licen�¢ �aw tloes no[ apply lo an owner of a property who bulltls or improves the�eon, antl who tloes such work�hlmself/herself or (hrough his or her own emplbyee5, provitletl that such imp�ovements a�e �ot Int¢ntletl or p{fe�etl to/ sale. I7,'hOweve�, lhE builtlin9 0� imprOvement i5 Soltl wi[hin one Yea� Of com- i p1eU0n, t�e owner will have [he burtlen of proving�he/she tlitl mt Euiltl or im- I�iOvq fo� lhe pur0o5¢ Of sale). - ; , U I,�as owner ot the properry, am exclusivety oontracting wltn Ilcenzetl con- tractba to construct [t�e project (Se<tion 7044, Business and Proiesslons Gotle: Th¢ Cont�actor'S Llcense Law tloeS nOt apply to an owner of property who bulltls or improves thereon, antl who mntracts for zuch pro�ects with a con- trattbr(sl licenze pursuant to the Contrac[or's License Law). I am aware�that prooi of [neir Worker's Compensatlon insurance should be pwvitletl to me. ❑ I am ezempt untler Section � B. & P. C. �or this reason I Date Owner � � � I hereby certify'that'I nave reatl thls application antl state [hat Ihe above IMormation is corrett. I agree to�comoly with ali city antl county ortlinances antl state laws relati�g to bWltling construction, an0 nereby au��orize re0re- sen[ative5 of tni C�ty/ t0 ente� upon the aDOve-mentiOnatl P�operty fo� • IOSOQCflOf1 ��/ � � � � `'� L• ,f Signafur �'��—�`�� Date �a U � DrivBrs' L Cense or 55 � � 7YPE OF CDNS7RPJ1CTION U NEW LJ ADD LJ ALTEAATION LJ AEPAIR ❑ CONVERSION ❑ OEMOLISH ❑ OTNER Ap � OESCRIPTIONOFWORK/USEOFBLDG. ��'��C �p2 � � yy� p S. Main Buildin9: TVPE'OF PERMIT GRADING FOUNDATION STRUCTVRAL � T Front ❑ TENANT�❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Reef - . ❑ �OTHER . - - � A PROJECT DESCRIPTION SQ. FT. 'oCCuvANCv C Right K Left CONSTRUCTIONTYPE VALUATION$ $ ZONE GRADING CV. VDS. ACRES p�ng. Ref. # Remarks: - �.} �Q�'_� ^�� p.�'�� PlanningNOtes: 0 Preventer Irrigation Clarifiers Drinking Fountains Floor Drains Floor Sinks Gas Service - Outlets, Interceptors Kitchen Sinli Lavatories . � P-Trap Roof Drains � Reinspettion Fee $15 Boiler ' Duct - Under Ground ' � Duci � Svucmral Duct -_Ventilating Ezhaust System ❑ Multiple Firepl/FacL BIt. IC80 �I`- Heating System & Ducting ❑ ai oo,000 sTu O i oo,000 Reinspettian Fee � $15 GMF pg65-46, rev. 4/84 White - BUIIEing; Canary - ApP��nt; Pi�k - Accountlnq; Gold¢nrotl - ASsesso� PLUMBING Showers ' Service Sink � Sewer Cap Sewer Connection Z Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa - Urinal - Water Closet Water Heater Water Service L FEES � Issue Fea� � � $ 3 IANICAL FEES ' Hood or Typel ❑ Canopy Type 11 ❑ Refrigeration System ❑a�oo,000sru ❑ioo,000aru System Repair/Alteration � Issue Fee � $ 3 .U. tior Pole Sub. Uni[ Boxes Switches Garbage Disposal Generator 00.5 KW 8889 3/07/85 �� Zone Accessory Building: . i , Parking Req./Provided ELECTRICAL Transformer ❑ 15-50KW O SO+KW Meter ❑up to 700 amps Meter ❑over 100 amps Sub Panel � I Mowrs 0.1HP�1X-8 � Inc.Solar �9-15 HP �16-15+ Microwave �. Pole Light flange . Sign �Standing Sections 5 KW Trosh Compactor � Reinspxtion Fee I $}5 DEVELOPMENT SERVICES REQUI ZoninB APProved By Building Approved By Appliration Issued By Issue Fee SUMMARV BUILDING PERMIT $ PLAN CHECK � $ � PLUMBING $ O PLAN CHECK 25% $ ELECTRICAL $ �I'•iC� PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ -1 G.70 . 1'L Z O N I N G R E � M T S. FEES f $ 3 FEES SMIP $ �PERMIT � ISSUANCE . $ ENERGV P.C. $ � GRADING $ MICROfILM S TOTAL FEE $ ( � � 7O - CONSTRUCTION AND PLANNING . � � POOL & SPA , `, APPROVALS Permit # Date Inspe�tor • pppROVALS Permit # Date Inspector ,1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. •- 53. Steel Reinforcement • Y 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 Gmd. - � � 57. APPROVAL TO COVER-GUNITE 7. Footings . � - 58. Electrical Conduit-Undrgrnd. � 6. Foundation - ' S9. Gas Pipe, O Undrgrnd., Test � • 9. Water Pipe-Undrgmd: - � � 60. Backwash Lines, P-Trap, O Undrgrnd. ]0. Structural Floor System 61. �APPROVAL TO DECK � - 11. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final � 12. Sewer Cap � � � . 63. Heater & Vent-Final , � � 13. Roof Drains 64: Plumbing System - Final - ., 14. Rough Plumbing � 65. Electrical-Final : 15. Rough Electrical-Conduit 66. Solar System-Final - - - 16. Rough Electric Wiring . 67. Fencing & Access Approval � -� 17. �Rough Wiring Sign . � - 68. APPROVED FOR PLASTERING 18. RoughElectrical-T.9arCeiling 69. POOUSPASYSTEMSFINAL 19. Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT 20. Fough Factory Fireplace � APPROVALS Permit # . � 21. Ducts; in Structure 70. Underground Hydro � 22. Ducts, Ventilating ' 71. Product Piping O Gas ❑ O,il � 23. Gas Pipe-Rough & Test -. 72. Underground Flush � 24. Roof Framing, . � 73. Undergrnd. Storage Tank 0 Gas ❑ Oil • 25. Roof Sheathing , 74. Overhead Hydro 26. -T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � - 27. Frame an8 Flashing 76. Dry Standpipe � � 28. Lathing & Sidin9 77. FIXED SYSTEM FINAL 29. Insulation ' 78. FIRE PREV. FINAL ' 30. Drywall Nailing ' , - HEAITH DEPT. FEQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � �/ �'j' ��f Notes: Y!/L!j'� (��G'¢q,Q, (.,Ep 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 pomes[ic-Final . � � �O � 42. Backflow Preventer ' . 43. Backflow.lrrigation . ,. A_�, �. . � � � 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations . � 47. FINALSTRUCTURE & BUILDING 48. Special Requirements Completed � � ' 49. Electrie Release to Edison � . 50. Gas Release to Southem California Gas Co � �� . ' 51. CERTIFICATE OF OCCUPANCY No. - Date � , " � . SOLAR HOME•GUARD CONTRACTORS INC. COLLECTORS GEN. PLtJM81NG DIA. � ~' ' SOLAR SYS. �-%"�� _ �'' P.W. II-84 i i .� . � / - '� i i _ �- _ ij .� � � , COLD -► HOT �- OPEN LOOP� ACTIVE SOLAR SYSTEM GAT E VALVE CHECK - VALVE � PETCOCK � GAS THERMOSTA MIXING VQLVE HILLER BYPASS - �BYPASS W�H i 0 ri; HEATER P&T ANODE ROD RAIN � STORLIGE TANK HGG25' I R VENT GALV. FLASHING 12 VDC --•• SENSOR IOKOHM '3/4 COPPER �My PI PE INSULAT ION HOSE BIB - - I I 0 VAC :ON RT OLLER -PUMRQ7AMP HECK VALVE♦ SOLATIONVALVE IELECTRIC UNIONS �' P & T -DFP TUBES �y ..__ ?y�,. � 5�� ..,, Jo�� . 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