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Home My WebLink About773 SCOTT PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 773 SCOTT PL REAR OFPROPERTY 42417205 ,4pp�icant: SHINE, ROBERT J Address: P O BOX 3278 - COSTA MESA, CA Owner: SHINE, ROBERT J Address P 0 BOX 3278 �'- Contractor. Address: ISSUE FEE Temp service lest Res. alc package New Res (1-2 unifs) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets sW�mnes Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 7 hp Motors to 10hp Motors to SOhp Molors to 100hp Molors over 100hp Communica6on drops Sub panel to 200a Pole Light Pkg Siqn CircuiLs Temp Pwr Pole COSTA MESA, CA OWNER-BUILDER Phone: 949-631-6636 Zip 92628 Phone: Zip: 92628 � Phone: Zip: License: 000000 ISSUED BY: SCOPE OF PERMIT INSTALL 3 NEW A/C UNITS FOR UNITS A, B, AND C LOCATED AT REAR OF PROPERTY. azs.so $0.00 354.50 $0.00 50.00 $0.00 $0.00 $0.00 so.00 $0.00 50.00 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 so.00 50.00 $0.00 $0.00 $0.00 $0.00 Quantiry 0 0 0 0 0 0 _ .0 0 0 0 0 0 0 0 0 0 0 p 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway I100 ft Standing Section Misc Electrical Equipment Transformers up to�1 kva/kw ................up to 10 kva/kw .:...............up to 50 kva/kw ...............:.up to 100 kva/kw ..................over 100 kva/kw Low Vollage Equipment Low Volt Wiring System I Ckt Misa Conduil Misc. Conductor Cirws ( gen or ride) � Circus (mech nde-or lights) Christmas Tree Stand ' Fireworks Stand. - , Other Eleclrical Fee . Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 04/OS/2005 Issued: 04/05I2005 Quantity ao.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 - 0 so.00 a $0:00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $000 0 � $0.00 0 $0.00 0 aios.00" , $0.00 50.00 $0.00 TOTAL CALCULATED FEES E187.00 NOTICE: Tha work authorized by this permit shall comply w0h all applicable handicap access requiremenis under Calitomia statutes and related regulalions. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit.shall automatically explre and become void if work Is not commenced within 180 days, or if work Is suspendeU or abandoned br a pedod of 780 days. INSPECTIONS: In ordar for the work authorized under this permit to be considered legal, such woAc must comply with all applicable codes, end all raqulred Inspectlona and tlnel approval must be obtained. Failure to obtain Inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaae�e �e�oo� WORKERS'COMPENSATION DECLARATON: � I hereby eKrm under penelry ol perjury one of tha toliowing decleretions: ❑ I have end will melntein e certifcate of cortsent lo sell-Insura lor workers' compensation, as provided br by section 3700 of the Labor Cotla, for ihe pertortnance of Iha work for which ihi5 pertnll i5 fssued. ❑ I have end vrill meintein workers' compen5afion insurance, as require0 by secUm 3700 of the LEbor Code, for the perfortnarice of Ihe work for whlch this p¢rtnit is iuued. My workers' compensetlon Insurence cerrier end policy number ere: Cerder: Policy Number. (ThIs secfbn need nof be complefetl i! Me pertnit is va/ued el one hunareC dollers /S I00) or IessJ cgrtily ihat in ihe pertortnenca af ihe work for whlch Ihis permil is Issued, I shell not employ eny person in eny mennar so as to becrome sub�ect to the worknro' compensatbn lew9 01 Celitomia, end egree lhet il I shoulC become sub�ect to Ihe workers' compensatlon provisions o1 Seclion 3700 af Ihe Lebor Coda, I shell forthwilh comp�ty wiih t^hese, � � lons. n MPIwaIIf gn8-�,.s�Nra' '� Dete: �T— F�i� — �!S WePNNKS.'KA LI URE TO 5 CURE WO KER COMP IdJ COVEMOE IS UNLAWFUL M10 SHALL SUBJECT AN EMPlO R TO CFIMINAL PENALTIE$ PND CML FlNES UP TO pNE HUNDRED T/1(%1SAND OOLURE (E100,000), IN A TO THE W9T OF COMPEN9ATION, DAMAOES AS PHOVIDED FOR IN SECTION 3/p60F THE LABOR CODE. IMERE$T. AND ATTOfiNEV'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby eNirm thet I em Iltensed under provislons o1 Chepler 9(commencing with Sectlon 7000) of Divislon 3 ot Ihe Business entl Pwfessions Code, antl my Ilcense i5 in full torCO Bnd 0tf0G1. Lia M CI059 M Comractar's Signeture: Dnte: CONSTRUCTON LENDING AGENCV: ❑ I hereby aftirm that Ihore is e consin�ction lending egency tor Iha peAormance ol Ihe work lor which Ihis permit is issued. (Sec. 3097, Civil Cotle). Lender's Neme: Lender's Addres9: Signelure: Dete: OWNER•BUILDER DECLARATONS: I hereby ettirtn thet untler penelry af perjury that 1 em E%EMPT FROM 7HE CONTRACTORS LICENSE LAW tor I�e lollowing reeson (Sec. 7031.5. Business anA Professions CotlB: Any ci�y or county whiCh reduires e pertnit to con9trut�, elter, improve, tlamollsh, or repeir eny siructure, prior to its Issuence, also requires t�e epplitant for such permit to tile e sipned stetement ihet ha or she is IicenseA pursuant to t�e provlsions ol t�e Cantrectors License Law (Chepter 9(commencing with Section 7000) of Divlsion 3 ot the Business end Professions Cotle) or thet �e a she is exempt therefran eiW Ihe besls for Ihe ellepetl e:emption. Any Ndatlon of Seciion 7031.5 by any applkant For a pertnit subjects t�e epplicant to e civil panalry ol not more t�an Iive hundred ddlars (5500)J: ��es owner af the proparty, ar my employees wlih weges es thelr sala compensetlon, WILL DO TME WORK, end Ihe siructure is not intenOeE or oflered for sale (Sec. 7044, Business entl Protesslons CoOe: 71ie ConUactors License Law does not epply to en owner ol property who builtls or improves thereon, and who Coes such work �imself or herselt or t�rough �is or her own employees, provitletl that such Improvemen�s era not intended or oHered lor sale. Il, however, the building or improvement is sWd within one yaar ot completion, the ownerUullder will have the burden of provinq ihat he or she tlid not build or improve tor purpose of SaleJ. ❑ I, a5 owner of Ihe D�WertY• em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the O�oject (Sec. 7044, Business and Protessions CoCe: TTe contrectors License Lew does not eppty to an owner ol property who Dullds or Improves thereon, and who contracts for such projea with a contracmr(s) Jimnse,pursuant to t�a Cwtractars License Laws.). tem verlticetion BuSiness and Protessions Cotlo for �his reason: s. —p ves p No of document, i.e. • propeM �e: CIII or DIVISION OF INDUSTAIAL SAFETV PERMR CER7IFICATION: ❑ I hereby certity thet no esravation five (5) or more �eet in tlepth into which e person Is requireC to tlescen0, will be made in connaction with work authorizetl by t�is pertnit, entl f�al no builtling siructure, scaMdding, talsework, or demWi�ion or tlismentling Ihereof, will ba more ihen ihirry-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Ttle 8, Celifomia Atlminisirative Cotle). � As owner-DuilAer, I wlll rwI employ flnyone to do work which would require e permit trom the Division ol Industnel Safey, as notetl aDove. unless wch pqrwn has a pertnit �o do such work trom Ihe divLsion. Signature: Date: Division of InduS�rial Salety Permi� Number: CERTIFlCATE OF COMPLIANCE AND AIffHORQATON OF EMRY: I cenity untler Denalty ol perjury that I have reetl �his apD�ication and state thal lhe information given is wrrect. I egree to wmply wlth all stete lews antl clty aralnances relating lo bullding consimctlon, end emhodze representetives of Ihe City of Costa Mesa to enter upon ihe above�describetl D�o � or ins ectio purposes. l pr e aol b occupy ar ellow occupartcy ol any huilding aulhorimd by lhis permit until linal inspecUon. � wb.. . �,�.—� tur � r.Cega rls); ;.".5;%.--.. �G�� o�aa n'G"'� i. � ..._- . . � � ... �"`� ;�.�+:T -r"–" An AuthonzeE Applicent Da�e COOE /, INSPEC110XTYPE tfit8 Fixed System Final Fire Prevemlon 1266 Pool Spa Finel 200 Flnal RB�Roo� 201 Finel BIocWRetelning Well 202 Final FeCtory Fire Placa 203 Final Sign 204 Final Domolitian �g �¢ j�f( INSPECTIONTYPE 206 Final Mechenical 20B Finel PIum6ing 210 Final Elecldcel 212 Finel Flre Preventlon 220 Finel Planninp Approval 222 Final Si�a 250 Finel Builtling/Occupency �F / d • .iw. (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 773 SCOTT PL Suite No Vicinity: UNITS A, B, AND C Parcel Number: 42417205 Applicant: Address: Owner: Address: Contractor: AdAress: SHWE,ROBERTJ� P O BOX 3278 / ,' . , ,�COSTA'MESA; CA . � , �, SHINE, ROBERTJ". � " � P O BOX 3278""- / � �`, '.' COS,TA-MESA, CA / :, OWNER-BUILDER i � / yr / \ � MECHANICAL PERMIT � , Phone: 949-631-6636 , . Zip: . 92628 . , , - Phone: Zlp: ,:.92628 � ' �. '.' Phone: Zip: License: 000000 StaWs: ISSUED Applied: 04I05/2005 Issued: 04/OS/2005 ISSUED BY: � SCOPE OF PERMIT INSTAIL 3 NEW A/C�UNITSFOR�UNITS A; B, AND C LOCATED AT�REAR OF PROPERTY. REF.: E05-00285 . � . . � _� ' .' . ' _ � _ _ ,_. � MECHANICAL TO INCLUDE: 3 COMPRESSOR/ABSORPTION SYSTEMS UP TO 3 HP. . :- - FEE SUMMARY , Tluantity � � ` ��'� ISSUE FEE � $23.50 Repair / Alt Absorbtion Unit Inst FAU <100 k BTU $0.00 0 Repair / Alt Refrigeration Unit Inst FAU >100 k BTU $0.00 0 Ventillation System , Repair / Alt Cooling/Heat . $0.00 0 . Evaporative Cooler - a... ; Inst / Rep. Recess Wall Hti.,'� $0.00 0 -• ,� � ��y' � ^ �Commercial Incinerator ' , Refrlg Sys <100 k BTU � � $0.00 0 .'S' � � � ' Domestic Incinerator ' Refrig Sys >100 k BTU ' � '. . $0.00 0 . ' - Comoressors / Absarption Svstems �-� Gas Piping - � \ , � $0.00�: _.-0 . , � Up to 3 hp / 100.k BTU�- � � ' Factory Fireplace ` '�; $0.00 0 " ' � � 3 To 15 hp / 500 k BTU � - - , Hood w/Mech Exhaust , j $0.00 ;, 0 , � - 15 To 30 hp / 1,000 k BTU "- ' VAV Box - � ' $0.00� = 0 ; � 30 To 50 hp / 1,750 k BTU % � � -� Vent Fan / Single Duct"- � /�', $0.00 '0� �� . �Over 50 hp /.Oyer4;750 BTU� - � � `� � Appliance . ' -, �� $0.00�`� 0 � � ' - _ - Boilers _ - ' � , � . Fire Dampers ` �; � �. � .$0.00, , 0 ,� � Up to 3-hp _ , � � . , Smoke Dampers �, $0.00 � �0 � - 3 To 15 hp ,' - � ' � , - Inst or Relocate Appl Vent �` '$0.00 � 0 �, . 15 to 30 hp .� Air Handlers < 10000cfm ,$0.00-. 0 � 30 to 50 hp � - - � Air Handlers > t0000cfm $0.00 �0 � - , , , Over 50 hp" � � . , FloorFurnace $0.00'��0�� .. OtherMechanical'Fee ' Floor or Suspend Heater $0.00 0� ' .., . Investigation Fee - Plan Check Fee $0.00 $0.00 $0.00 ' $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 i,$0.00 � $44.10 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 Q, . , 0 0 ; 0 � � � � � 3 0 0 0 0 I NOTICE: The work authorized by ihis permit shall compty with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 7241-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspeetlons and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 754-5626 I eaco-aa �aw) WORKERS'COMPENSATON DECLARATION: � � I hereby aHirtn untler penalry af perjury one of Ihe following decleretions: ❑ I heve en0 will meintein e certificete of consenl to sall-Insure br workers' compensatlon, es provitled for by section 3700 of the Lebor Cotle, for the pertormence of the work tor which Ihis pertnit is issuetl. ❑ 1 hava enC will meintain workers' compensation insurence, es required by Section 3700 0l the Lebor Code, for the pedortnance of ihe work Por which this pertnit is issued. My workers' compensation Insurence cerrler end policy number ara: Cartier: Polity Number: (This sectbn naed nof be crompleted i! the permi( is velued et ane hunOretlOollars ($ f 00) or less.) � I certiy thel in the peAortnence ol the work for which Ihls pertnit is Issued, I shell not employ eny person in eny manner so a9 ro become subject to the worknrs' compenseilon laws o� Celifa ie, end egre ihet I� 1 should become sub�ec� �o the workers' compensetion provlslons of Section 3700 of the Lebor Code, I shell fotlhwith comply with these provi i s, �' �^ Applicant Signature: Date: � � `� il=Q� WARNING: FAILURE TO SECURE WORKERS' DMP N AT10N pVE GE IS UNLAWFUL RND SHALL SUBIECT AN EMPLWER TO CRIMIN/d PENQTIES AND qVIL FlNES UP TOONE HUNDRED T/%%1SANDOOLL4RE(StOJ,000),INADDITI TOiI'ECOSTOFCOMPENSATION,OAMAOESASPROVI�EDFOqINSECTION3lO60FTMELABOqCODE,IMEREST,ANDATTORNEVSFEES. LICENSED CONTAACTORS DECIARATION: I �erehy aRirm t�at I am licensed under provislons ol Chepter 9(cammencing wlih Seclion 7000) ol Division 3 of tha Business and Pwfessions Code, antl my license is in full farce and eftect. lic. M Class � Contraqor's Signature: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby attirtn that there is e consiruction lending egency for the pedormance ol lhe work tor which this parmit is Issued. (Sec. 3097, Civil Code). Lender's Name: Lentler's Atldress: Signature: OWNER-BUILDER DECLARATONS: Dete: I hereby aHirm Ihat unaer penalry of per�ury ihet I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, eusiness en0 Protesslons Cotle: Any ciry or crounry whic� requires e pertnit to construct, elter, improve, tlemolis�, or repair eny structure, prior to its issuance, elso requires Ihe applicant tor such pertnit to fila e signed statement t�at �e or s�e is Iicensed pursuent to tha proNslons al Ihe Cantractors License Law (Chepter 8(cammencing with Section 7000) of DMsion 3 of the Business antl Professions Code) or that he or she is axempt thereirom end Ihe besls for t�e ellegotl e:emption. Any violation of Sectlon 7031.5 by any applicant for a permit subl�s the epplicent to e civil penalry of not mare then live hundred tlollers (5500).): � I, es owner ol tha property, or my employees wilh weges es iheir sole compensatlon, WILL DO THE WORK, end Ihe structure is not iniendeG or otteretl for sala (Sec. 7044, Business antl ProFessions Code: The Contractors Licansa Law doas nol apply to en owner of properry who builOs or improves thereon, and who tloes such work himsetl or herseN or ihrough his or her own employaes, provided ihat suc� improvemants ere not intentled or ottered lor sale. If, however, the building or improvement is soltl within one year ot completion, the ownervUuilder will have ihe burden ol proving that he or she did not builtl or improve for purpose of sale.). ❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct t�e project (Sec. 7044, Business and Pmfessions Cotle: The conireaors License Lew tloes not epply to en owner o/ property who bullds or Improves Ihereon, and who coniracis lor such project with a wntractor(s) license pureueni to t�e Contrectors License Lews.). �j I em ezt Signeture: _ Ownar ID ven Venfication oi Business an0 Prolessions Cotlo lor ihis reason: Ves � No ol tlocument, i.e. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CEH7IFICA710N: Drivers License No. ❑ I here�y cartity ihat no excavation live (5) or more feet in depth into w�ich a person Is required lo descend, will be made in connection with work aut�oAzed by t�is pertnit, and that no building sifucture. scaflolding, falsework, or demolition ar dismantling ihereof, will be more than ihirry-six (36) feet �igh. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle B, Calitomia Atlminisiretive CoOe). ❑ As owner-builtler, 1 will no� employ enyone Io do work which wouid requlre e permit from ihe Division of Industriel Setery, as noted above, unleu such person has a pertnit to do such wark tram the divisian. Signeture: Date: Division ol Industnel Safety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUfHORIZATION OF ENiRV: I cenlfy untler penalry of perjury that I have read ihis epplicalion and state chat the information given is wrrecL I egree to wmply with ell stete laws antl city orAinences relating to bullding conslrucllon, entl auNorize represemetives of t�e Cily of Cwta Mesa lo enter upon ihe ebove-descnbed/�ro erty for inspe ion purpo eqree not to occupy or ellow occupanry at eny building authorized by ihis permil until linal inspeqion. 1S �i'�s'��n,Y.. . �'� ' O �—F� � ian re OI ner(sl Date COOE t. INSYECTIONTYPE 1818 Fixed System Pinal Fire Prevention 1266 Pool Spe Final 200 Finel Re�Raol 201 Flnel BIocWRetalning wall 202 Final Fectory Fire Place 203 Finel Sign 204 Finel Demolition p1TE INTRIAL9 COOE I INSPECTION TYPE 20fi Final Mechanical 20B Final Plumbing 210 Final Electrical 212 Flnal Fire Prevenllon 220 Final Planning Approval 222 Final Sile 250 Final Building/Occupency Date � _ . / �� .W (714) 754•5273 • Fex (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Jab Address: � 773 SCOTI' PL Suite: A Vicinity: CLOSET IN UNIT A Primary Occ: R Parcel Number: 42417205 Applicant: SHINE, ROBERT J Address: P O BOX 3278 . WSTA MESA, CA - Owner: SHINE,'ROBERT J Address P O BOX 3278 , . - COSTA MESA, CA � Comractor: OW N E R-BU ILDE R Address: Type of Construction: V-N Zoning: Phone: 949-631-6636 Zip: 92628 � ' � Phone: Zip: 92628 Phone: Zip: License: 000000 Arch :� ' • --. Eng: . Address: � ' - - ' ' ' � � Address: Phone: Status: ISSUED Applied: 04/O6/2005 Issued: 04/O6/2005 <' V � ISSUED BY: Phone: 'r Zip: , . License: � License: _ SCOPE OF PERMIT _ CONSTRUCT 18" HIGH PLATFORMS LOCATED IN CLOSETS�FOR HEAT PUMP UNIT AND CREATE AIR INTAKE FOR VENT LOCATED ON CLOSET DOOR FOR UNIT A. �� - -� Plan Check: $0.00 Permit: $54.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $54.50 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0.0 PARKING Existin : 0 FEESUMMARY PLANNING & ZONING Rear 0- 0 � Left 0- 0 Rear 0- 0 Left 0- 0. Reauired: 0 Pr000sed: 0• Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $1,500.00 s�,soo.00 0 NOTICE: The work authorized by this permit shall comply with all applicabie handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-g2) 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 ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetiona and (inel epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration ol this permit. FOR INSPECTIONS CALL: (714) 754•5626 �� aw� WORKERS'GOMPENSAnON DECLARATON: � I hereby eNirtn under penelry ol perjury one ot the following declaretlons: ❑ I heve end will maintein e cerlHicete ot consent lo sell-Insure lor workers' compensetlon, as p�ovided for by sedion 3700 of the Lebor Code, for the pertortnance of tha work for whith this pertnit Is is5ued. ❑ I have end will maintain woMere' cnmpensetion insurence, es requiretl by section 3700 ot ihe Lebor Code, for the peAORnance of the work tor which this pertnit is iswad. My workars' crompansetlon Insurence cartler end pollcy number ere: Cerrier. Policy Number. (Thls sectlon need not be comp/efed i! the permit is veluetl e! one hundretl tlollers (S100J or /ess.) � I certiiy that in the peAortnence ol Ihe work for which Ihis permit is issuetl, 1 shell not employ eny person in any manner so as to Decome sub�ect to the workers' compen4ation laws of Cel omia en egrae lhet it I should becoma sub�ect to Ihe workers' compensation prwislons of Section 3700 of the La�or Code, 1 sha0 forthwith compy with Ihese pro i is. � ,, � �,Q ni ApPlicant Signature: , ' Dete: ��.L v{-L_ WARNING: FAI�URE TO SEC RE WORK S' OMPE OpVERAOE IS UNLAWFUL AND SHALL SUBIECT rW EMPIOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDREO T11IX15AND DOI�RE (5100,OJO�, IN AD I TO THE WST OF COMPENSATION, DAMAGES NS PROVIDED FOR IN SECTION ffip6 pF TME L4BOP CADE, lMEREST, ANp ATTpFiNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby e8irm ihat I am licensed untler provisions of Chapter 9(commencing wilh Section 7000) oi Division 3 01 ihe Business antl Pmfessions Code, and my license is in tull forCe end efrecL Lic. d Class M Conirector's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that there is e constmcfion lentling agency lor Ihe pedormance of Iha work lor which ihis permit is issuetl. (Sec. 3097, Civil Cotle�. Lendeis NamB: Lender's Addrass: Signeture: OWNER-BUILDER DECLARATIONS: Dete: I hereby ettirtn that under penalfy ol perjury Ihat I em EXEMVT FROM THE CONTRACTORS UCENSE LAW for the lollowing reeson (SecJ031.5. Business an0 Protesslons CoAe: Any Ci�y or coun�y which raquire5 e pertnil �o construct, el�er, Improve, demolish, or repair eny structure, prior to its issuance, also requires t�6 applicant fOr such permit ro fila e signed statemanl Ihet he ar s�e i9 Iicensed pursuent to lhe proNslons ot the Contrectore License Law (Chapier B(commencing with Seclion 700p) of Dlvisirn 3 of Ihe Businass end P�ofessions Cotle) or thet ha or she is exempt therafrom entl the basis im the eNegetl axemption. Any viWation of Section 7031.5 Dy any applicaN tor a pertnit subjects tha epPlicant to a dvll penelry of nat more than Ilve hundred tlollers (5500�.): � I, es owner of the properry, or my employees with weges es Ihelr sole compensation, WILL DO THE WORK, entl the siruciure is not intended or offered lor sale (Sec. 70a4. Business and Professions Code: The Contractors LicenSe Law does not epply to an owner oi properry who Ouilds or improves Ihereon, antl w�o does such wotic himself ol hersetf or t�rough �is or her own employees, provided thel such Improvements ere not Intentled or oflered for sale. tl, however, ihe Guilainq or improvement is sold within one yeer o� completion, the owneo-builder wlll have tho burden of proving thet he or she tlitl not build or improve lor puryose of sale.). ❑ I, es owner of the proDerty, em E%CWSIVEIV CONTRACTING WITH LICENSED CONTRACTORS to con9truct the pmject (Sec. 7044, Business and Professions Cotle: 7Te contrectors LlcenSe Lew tloas not epply to Bn owner of pmperty who bulltls or Improves Ihereon, antl wh0 wntracts for 9uch projed with a con(ractor(s) license pursuant to the Contradors License Lews.). � I em ezemp n r Signaiure: Owner ID veriFi by drivi Veritiwtion ot Ownership Business entl Professions Cotla lor ihis reeson: iB. QYes ❑ No OriveYs License No. ol document i.e. - D�oDerry tax bill or Oeed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION: Expires: ❑ I hareby Certify that no axcevetion tive (5) or more feet in depth into which a person is required to descend, will be matle in wnnection with work authonzed 6y this permit, and that no building struclure, scaHolding, falsework, or demolition or dismantling thereof, will Oe more then thirry-six (36) feet high. (C�ap. 32, Gry 2, An 2, Sec. 341, Ttle B, Califomie Administretive Code). ❑ A5 owner-Duilder, I will nol employ enyone to do work which would repuire a pertnil irom �he Division of Indusinal Salery, as notatl abova. unleu such person has a pertnit to da such work Irom Ihe Civision. SignaWre: Date: Division oi Intlusirial Safery Permit Number: CER7IFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRY: I cenily under penalty ol porjury ihet I have read this epplication antl s�ata Ihal the information qiven is correct I egree �o comply wlth ell stete lews end city orGinences reletlng to Ouilding consimclion, and euthorize represeNa�ives ol the Clty ol Costa Mesa to emer upon Ihe ebove-desc rop 1QI[1mspet(y��1�p�urposes. l sqree nm to occupy or e11ow cecupancy ot arcy builtling aulhorized bCy 1this �mit uM/il final insp�ect+ion. A��, 0 _'V'iIM�J M1l� �f7 ��.J ian Of Legal Ownerls) Dale GOOE 1. INSVFCTIONTYPE PA7F INTR11L5 7616 Fixed 5ystem Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Fe-Root Final BIocWRe�alning Wall Finel Fac�ory Fira PlaCe Final Sign 204 Finel Demolition CODE� INSPECTIONTYPE 206 Flnal Mechanical 208 Finel Plumbing 210 Finel Eleciricel 212 Flnel Fire Prevention 220 Final Planning Approval 222 Finel Site 250 Final Builtling/Occupency Qsif. u�$ (714) 754-5273 • Fax (714) 754-4856 • www.ci.coste-mesa.cBUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 773 SCOTT PL Suite: B Vicinity: CLOSET IN UNIT B Primary Occ: R Parcel Number: 42417205 npp�icant: SHINE, ROBERT J Address: P O BOX 3278 COSTA MESA; CA �- � Owner. SHINE, ROBERT J . Address , P O BOX 3278 � � - �� , �COSTA MESA;�CA - � � Contrectoc OWNER-BUILDER Address: . � ;. - � StaWs: ISSUED Applied: 04/O6/2005 Issued: 04/O6/2005 Type of Constmction: V-N Zoning: Phone: 949-631-6636 - Zip: 92628 � �, - Phone: � � Zip: 92628 � � . ` . Phone: =L� � 000000 I,/� � /'. �• � � �,N. icense. , , , . � . . , , . . , . ., , � Arch.: ` , ^ . � - ' Eng: . � . • � . , . , .' '� , �'' - , � Address. ' • �'` ' ' . � Address: , ,.Phone: � Phone; Zip: % License: � License: SCOPE OF PERMIT. CONSTRUCT 18" HIGH PLATFORMS LOCATED IN CLOSETS FOR HEAT PUMP UNIT� AND CREATE AIR INTAKE FOR VENT LOCATED ON CLOSET DOOR FOR UNIT B. �'" - "' �- - � " - � � " `" - Plan Check: $0.00 Permit: $54.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: ; $0.00 Total: � $54.50 FEE SUMMARY . ____ .- � _ - ; Calc Valuation: S�,soo.00 - % Claim Valuation: S�,soo.00 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Fronl �0-0 PARKING Existin : 0 � Rear 0- 0 Rear 0- 0 �-. Required: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Right 0- 0 Righl 0- 0 NOTICE: The work authonzed by ihis permit shall comply with all applirable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply wilh all applicable codes, and all requlred inapeetiona and final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 �� WORKERS'COMPENSAnON DECLARAnON: I hareby eHirm untler penalty ot pe�ury one oi the following decleretions: ❑ I heve end will meintein e certificete of consent to selbinsure tor workers' compensation, as pmvidetl for by section 3700 of Ihe La6or Code, lor the Dertormanca of Ihe �ya� for which this pertnit is issued. ❑ I hava antl will maintain workers' compensation insurance, es required by seMion 3700 of the Lebor Code, for ihe pertormance of the work for w01ch this pertnit is issuetl. My workers' cnmpensetian Insurence ceMer and policy num6ar ere� Certiec Policy Number. (This sectl0� �eed not be completetl il the permit is velued ef one hundred dollars ($ IOOJ or less.) � I cedity that in the perfortnance o� Ihe woM tor which this permil is issued, I shell not employ any person in any manner so as to become subject to ihe workers' compensetion lews of Calif mie, nd egree Ihe ' �ould become sub�ect to Ihe workers' compensatlon provisions of Section 3700 o t�e Lebor Code, I shell forthwith comply with these pro o s. /� ` Applican� S�9naNre: Dale: O� ^ � �CJ ` ) WARNING: FARUPE TO SECURE WOFlKE 5' C iMpENSA iN WVERAOE IS UNIAWFUL AND SHALL SUBIECt AN EMPLOVER TO CRIMINAI PENALTIES AND CIVIL FlNES UP TOONE HUNDRED TiOUSANDPaV1RE(E100.00p),INA�DI ION OTHE�SiOFCOMPENS/TION,DAMAOESASPROVIDE�FORINSECTIIXJ�060FTHELABORCODE,INTEREffi,ANDNTTOFlNET"SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHi� that I am licensed under provisions ol Chap�er 9(commencing wllh Sectlon 7000) oi Division 3 01 ihe Business antl Professions Code, antl my license is in full force antl eftect. Lic. a Class # Contrador'S Signature: Date� CONS7RUC710N LENDING AGENCV: ❑ I hereby attirm that there is a consiruction lending egency lor the performence of Ihe work for which this permit is issued. (Sec. 3097, Civil Cotle�. Lender'S Neme: Lender's Address: ' Signature: Date: ' OWNER-BU��DER DECLARA710N5: I hereby aHi� that under penalry of perjury ihat 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (SecJ031.5, Business antl Professlons Code: Any dty or county which reQuires e pertnit b construct, elter, improve, demolish, or repair any simcture, prior to its issuance, also requires the applicant for such permit to file a signed stetemant thet he or she Is Ilcensed pursuent to t�e provisions ol the Contrectors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of tha Business a�tl Pmfessions Code) or thet he or she is azempt therefrom and Ihe besis for tha alleged exemption. Any violetion o1 Section 7037.5 by any applicant for a permit suDjacts ihe applicent to e civil penalry ot not more than five huntlred dollars ($500�.): f� I, as owner oi Ihe properry, o� my employees with weges es their sole compensation, WILL DO TNE WORK, antl the siructure is not inientletl or ottereC for sale (Sec. 7pqq, Business and Professions Code: The CONractors License Law does not epply lo an owner of property who 6uilds or improves thereon, and who dces such work �imself or herself or through his or �er own employees, provided Ihat such Improvements ere not intentled or oHered lor sale. If, however, tha building or improvement is sofd W�t�in one }resr ot completion, ihe owner-builtler will hsve the burden W proving that he or sha did not build or improve toi purpose ot sale.). ❑ I, as owner of the propery, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the prolect (Sec. 7044, Business antl Protessions Code: The contrecrore Licanse Lew does not apply to an owner of property who bullds or improves thereon, and who contracts for such project with a contractor(s) IicensB pursuant to the Contracto�s License Laws.). lam Owner ID v��fied by Verificetion 0� Ownei BuSiness antl Proie55ions Code for �his reasOn: D e: ❑ Ves ❑ No Dnvers License No. � Expires: /n —//r-., � (rype oi documem, i.e. - property tea bill or deed): UIVISION OF INDUSTRIAL SAFETY PEHMIT CER7IFICATION: ❑ I hereby certity that no excavation five (5) or more feet in depih into which a person is required to descend, will be made in connedion with work auth0�zed 6y this permiL and that no building structura, scaHolding, talsework, or demolition or tlismantling thereof, will be more than thirry-six (36) feet high. (Chap. 32. Grp 2, Art 2, Sec. 341, Y��e B. Cali(omia Administrative Code). . ❑ As ow�er-builder, I will not employ enyone to do work which would require e permit from the Divislon of Industnal Safery, as notetl above, unless such person has e permit to do such work irom the divisian. Signature: Date: Division oi Intlustrial Safery Permit Numbar: CERi1FlCATE OF COMPLIANCE AND AU7HORVA710N OF ENTRY: 1 certify untler penalty oi perjury Ihel I hava read this epplication and stala ihat t�e informalion given is correct I aglee to comply with all slete I ws and ciry ordlnances relating to building constmction, end au�horize represematives of Ihe Cily of Cos1a Mesa lo enter upon ihe above-des i e prop tly fo in,pecti�rppses. I agree not to occupy or allow acupancy ot any builtling au�horize �y t� p/ermit until �i� nspeclion. Y �7 �.O � A. /I�� /lsionat LeaalOwner(s1 Dale GOUE �. NISPECiIONTYYE 1616 Fixetl System Final Fire Prevention 1266 Pool Spe Finel 200 Finel Ra�Rooi 201 FIn91 BIocWRetaining Well 202 FinB� Factory Fire Place 203 Fine� Sign 204 Fina� Demolition nt Date pATE �N[�I7eLS �Q.Q�1 INSPECTWNTYPE Qej( �$ 20fi Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Finel Flre Prevemion 22o Finel Planning Approval 222 Final Sita 250 FinelBuilding/Occupency �'�� (714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa. BUILDING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 773 SCOTT PL Suite: C Vicinity: CLOSET IN UNIT C PrimBry Occ: R Parcel Number: 42417205 Applicant: SHINE, ROBERT J Address: P O BOX 32�8 COSTA MESA, CA � � Owner: SHINE, ROBERT J Address P O BOX 3278 COSTA MESA, CA Contractor: O W N E R-B U I LD E R Address: Zip: Arch.:- , . . Address: � � ' ' Phone: Zip: License: Type of Construction: V-N Zoning: Phone: 949�631-6636 Zip: 92628 Phone: ' Zip: 92628 Phone: License: 000000 —. Eng: Address: SGOPE OF PER CONSTRUCT 18" HIGH PLATFORMS LOCATED IN GLOSETS FOR HEAT PUMP CLOSE7 DOOR FOR UNIT C. - � �� Plan Check: permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $54.00 $0.50 $0.00 $0.00 $0.00 $54.50 FEE SUMMARY SETBACKS MAIN S7RUCTURE �Fiont 0- 0 � Rear � 0- 0 ACCESSORY Front 0- 0 - �, Rear 0- 0 PARKING Existina: o _ Reauired: ,o PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 ISSUED BY: Status: ISSUED Applied'. OA706I2005 Issued: 04/O6/2005 ��I Phone: License: AND CREATE AIR INTAKE FOR VENT LOCATED ON Calc Valuation: Claim Valuation: RigFit 0- 0 RighC 0- 0 si,soo.00 51,500.00 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 void if work is not commenced within 180 days, or if work is suspended or abandoned for a period ot 180 days. INSPECTIONS: In order tor tha work authorizad under this permit to be consideretl legal, such work must comply with all applicable codes, and all required Inspeetlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of lhis pertnit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby effrtn under penalty o� perjury one ot lhe following declerefions: ❑ I heve end will maintein e certificate of consent to self-Insure tor workers' compensatlon, es providad for by section 3700 of ihe Lebor Cotle, for the pertortnance ol Ihe work for which this permit is issued. ❑ I heve entl will maintein workere' compensatlon insurence, es reqNred by section 3700 0l the Labor Code, lor iha peAormanca of t�o work for which this pennit is issuetl. My workars' compense�ion Insurence cerder end policy num6er ere: Cerner: policy Number. (Thls secNon need not be comp/eled il the permil is velued e1 one hundred dollars ($100J or less.) that in the per isetion lews ol with these om (5100.000),IN ol the work br which this pertnll Is is9ued, I shell nol employ eny parson in any manner so 85 to become subject b the workers' , end egree �het II I s ould become sub�ecl to ihe workere' crompensetlon provisions ot Sectioo 3700 ot t�e La�or Code, I s�all tonhwitfi � oe,a: �4- 0 6- o,� RS' MP NSATI EPAOEISUNIAWFU1.rWD5MALL5UBJECIANEMPLOVERTOCRIMINRLPENALTIESANDpVILFlNESUPTOIXJEFNNDRED 1pJ ECOSTOFCOMPENSATION,pAMAGESASPROVIDEDFORINSECTION3lO60FTMEL4BOqCODE,INfEREST,ANpqTTORNEI^SFEES, LICENSED CONTRACTORS DECLARATION: I hereby eBirtn tha� 1 am licensed untler provlsions af Chapler 9(commencing wi�h Secllon 7000) of DlviSion 3 ot the Business and Protessions Cotle, and my license is in full forCe end eHBtL Lic. b GI855 M Conirector's SignaNre: Dete: CONSTRUCTION LENDING AGENCV: ❑ I hereby aflirm that there is a consiruction lending agency br ihe peAormance ot IM1e work lor which this permit is issued. (Sec. 3097, Civil Cotle). Lentler'S Name: Lentler'S Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby elfirm thet under penelry of perjury Ihet I em EXEMPT FROM 7HE CONTHAC70R5 LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business antl Protesslons Cotle: Any dry or counry which reQuires e pormit to construc6 elter, ImOrove, demolish, or repeir any stmciure, prior to its issuance, elw repuires the applicant for such permit to file e signed statement ihet he or she is Ilcensetl pursuent to the praWsions of Iha Contractors License Law (Chepter 9(cammencing with Section 7000) ot Division 3 0l the Business and Professions Code) or t�et he or she is axempt therelrom end Ihe basl9 lOr the allegetl a:omption. Any violetion ol Section 7031.5 by any applicant for a pertnit s},u�b-j-e.c,.ts the applicant to e cidl penelry of nol more ihan five hundretl Aollers ($500).�: y,�, as owner ol Ihe property. or my employees wilh weges as their sole compensation, WILL 00 THE WORK, antl ihe siructure is not inten0e0 or otferetl for sale (Sec. 70ad. Business end Pro�essions CoOe: The Conirectors License Lew tloes nol apply to en owner ol property who builds or improves t�ereon, and who tloes such work himself or herseli or Ihrough his or �er own employees, provitletl that such improvemants ere not Inlentled or otleretl lor sale. Il, however, the builtling or improvement is sold within one year ol completion, ihe owner-builtler will have the hurtlen ol proving ihat he or she did not build or improve tor purposa ot sale.). ❑ I, e5 owner of Ihe propefiy. am EACLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to constmct the prolect (Sec. 7044, Business and Pmfessions Cotle: The cronireclors L�cense Lew tloas not epply to en owner ol properly who builds or Improves ihereon, entl who coniracis tor such pmject wtlh a coniracmr(s) licensa pursuent to t�e Gontrectors License Lsws.). Busine55 end Protessions Code lor this reason: !Ouwerf�fied by driver ice �"ves ❑ No Vedlication of Ownership y( oi tlocument, i.a. - property Iex bill or deed): DIVISION OF INDUS7RIAL SNFETY PERMR CERTIFICATION: ❑ I hereby certiy Ihat no ex�evetion five (5) or more feat in depth imo which e person is requiretl to descend, will be made in wnnection with work authorizetl by Ihis permit, and thet no building structure, scattolding, falsework, or demolition or dismantling Ihereoi, will be more Ihan fhirty-si: (36) leet higR (Chap. 32. Grp 2, Art 2, Sec. 341, Ttle B, Califomia AtlminisVative Cade). ❑ A5 owner-0uiltler, I will �ot employ enyone to do work which would requlre a pertnit irom the Division ot Intlustrial Safery, as noted ebova, unless such person has a parmit to do such work irom the division. Signature: Date: Division ai Intlusirial Safery PA�it Numbar: CERTFlCATE OF COMPLIANCE AND AUTHORIZA110N OF ENfRV: I conily under penalty of porjury thal I heve read this epplication and slate Ihal the inlormation givan is wrrect. I egrae �o wmply wl�n ell slale laws en0 ciry ordfnances releting lo bullding wnstmctlon, enA euthodze representatives of ihe Clry ol Costa Mesa to enter upon Ihe above-descnbed pr e torj�spe tion DurpQ�6f Fagrea not to occupy or ellow occupency of eny builAing aulhorized �y Ihis per it unlil final inspection. ,}�'{— � ^�`/,J w�Nti+ �i F),6 �, ['� �'� [/�T�reOt I wner(sl.'c��' �, -_ �(,,,ti � Fi��b'�- COOE t. IHSFECTONTYPE 7616 FixeO System Final Pire Prevan�ion 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIocWReteining W ell 202 Final Factory Fire Ple�e 203 Final Sign 204 Finel Demolition OATE II(il➢9L4 4QQFa INSPECTIONTYPE 20fi Final Mechanical 20B Flnal Plumbing 210 Final Electrical 212 Finel Flre PreveNion 220 Flnal Plenning Approval 222 Finel Slle 250 Finel Building/Occupency �L\I�1`IIH!IF1 .:W Applicant to fill in all s0aces except those wilhin heavY Dortler lines antl si9n all approp�iale Geclarationi. CITY OF COSTA MESA CONSTRUCTION�PERMIT PERMIT NO�./ TRACT NO. � � LOT NO. � UNIT N0. , � Project Address '� %3 Sf D if �P<a�f � � � � L I � � � Applicant�s Mailing Address �0 Ro,[GSs f,�,.Tq ,�/VYJ f� �� Owner's Name O'7R N�r��rz�✓ Phone �p?i- t(.!7 Address 77? S�oTI' �.U9IR !JN T ii Arch/Eng. License No. � � ' Address Convactor's Name S/+:✓'A /9��F ,JG —� phone STL�-?7e� Addresslmailingl_P.(7.i4oX (Sf S.v..?� 9Z-7,o2 City License Na. LO 4S30fY � LICENSED CONTRACTOR DECLARATION ' . I hereby iHirm that I am licensetl untler provisions of Charte� 9(commencing with section 1000) of Divisfon 3 o�lt�e Business antl Professions Cotle, antl my license is in full force antl effect � License Class � � License No. Date Z ��'.G�' ' Si9nature �` _ '^ WORKERS'COMPENSATION pEGLARATI N l� I hereby attirm tnat, I have a certificate of.consent to selt-insure or a certificate ot Workers' Compensation Insurance, or a certifietl copy thereot (Section 3800, Lab. C.) ' � aoiicy No.��'S v�✓�T /Sq.� company STn'rS F�L4 ❑ Certifietl mpy is hereby fumishetl. � : jJ Certifietl copy Is filetl with the city Buil n visia�n./� � �� Date �-"��-� Applicant • �-/�/�-- EXEMPTION FROM WORKERS' COMPENSATI N DECL A/iR TION (Thissection neetl not be completetl i� the permit is for one huntlretl ($100) or less). , - I certify that in the pe�to�manCe of the work for whlch this pe�m�t is issuetl, I � (�-. shall not emDloy any person�in any manne� 50 a5 to become Subject to tlte V Workers' Compensatian Laws oYCalifOmia. � M Date '� Signature '�w NOTICE: It, after makin9�this tleclaration,-you shoultl become subject co the Workets' Compensation provisions of ihe Labor Cotle, y0u must forthwith I comply with such provisions on this permit Shall be tleemetl revoketl. CONSTRUCTION LENpING AGENCV I hereby affirm that there is a mnstruction lentlin9 agency (or the pertormance ot [he work for whith this permiY is issuetl (Section 3097 Civ. CJ I l.entler's Name Lender's AOtlresS �1 OWNER BUILDER OECLARATION I hereby affirm that I am exempt from the Conlracto�'S License Law for the lollowing reason (Section 7 W 3.5 Business antl Pro(essional Cotle: Any city or county whlch requir¢5 a permit to construct, alter, Improve, tlemoli5h or repair any structure, prlor to its issuance, also requires the applicant for such permit to file a signetl Statement that he/She is IicenSetl pursuant to tM1e O�ovisions o( the Contractor's License Law (Chapter 9(commencing with Section ]000) of Division 3 of the Bu5ine55 antl Professlons"Cotl¢)'or that he/she i5 exempt therefrom antl the Dasis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a�permit Subjects the applicant to a civil �enalty of nat more than five huntl�etl tlollars ($500). I, as owne� of Ihe property or my employees with waqes as tM1ei� sole mmpensation, will tlo the wo�k, antl the structur¢ is no[ intenGetl or offeretl to�.sal¢ (Section 7044,. BuSiness antl Pwfessional Cotle: The Cont�acto�'s License Law tloes not apply to an owner of a property who builtl5 or improves thereon, antl wM10 tloes such work himself/M1erself or throu9� hiz or her own employees, p�ovltletl that such improvements ate not intentletl or otferetl to� sale. If, however, the builtling or improvement is toltl within one year of com- pletion, the owner will have the buraen of p�ovinq he/zhe tlitl not builtl o� im- prove for the purpose of sale), ❑ I, as owner o� the property, am exclusively cont�acting wltM1 IicEnSetl con- tractors to wnstruct the project (Section 7044, Business antl Professions Cotle: The.Contractor'S License Law tloes no[ appty to an owner of property who builtls or improvez thereon, antl wbo cont�acts for such proje[[5 with a con- tractor(sl iicense pursuant to the Contractor's License Law). I am aware that proof O( tM1eir Worker's Compensation insurance shoultl be provitletl to me. ❑ I am exempt untler Section B. &'P. C, tor thi5 reason I Date - Owner I hereby certify [hat I have reatl this application antl state that the above information is correct. I a9ree to comply with all city and county ortlinances antl�state�laws relating to builtlin9 construction, antl hereby authoviie repre- sentatives oi this clty to enter upon the above�mentionetl Oroperty tor insoeGt�on pur es. Signdtur¢ Date 7. l�'iYi Drivers' License or 55 TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION� ❑;DEMOLISH ❑ OTHER Ap # DESCRIPTION OF WORK/USE OF BLOG. %E�� aFF �Ca�i� iPuo F / z Hcl �SAmE ' /-ZY"�LNJ /�yti* 2//6lYA ify iCoLrG S Main Building: - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front ❑ TENANT ❑ ELECTRIGAL �❑ PLUMBING ❑ MECHANICAL B Reat ❑ OTHER . � %:. . PROJECT DESCRIPTION ' SQ. FT. y 300 � OccuPANCv S�?L.�.1' K Right CONSTRUCTIONTYPE VALUATION$ �7/IJ•-� g Left 20NE � GRAOING CV. VpS. ACREST� ping. Ref. # ' Remarks: . . . � , Planning Notes: Bar Sink eackflow Preventer Backflow Irrigation Bathtubs Dishwasher Drinking'Fountai Floor Drains . Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee Outlets $15 BOiler Duct - Under Ground � Duct - Structurel Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO # Heating System & Ducting ❑0.700,000 BTU 0100,0008T painspection Fee � $15 CMF 0865-46, rev. 10/84 White - Builtling; Canary - Applicanh Pink - Accountin9; Goltlenrotl - Assessor Service Sink - � Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Sola� Tank Swimming Pool w/Spa Urinal W2IQI CIOS¢S Water Heater Water Service Auto-Wash Issue Fee Hood or � Type I ❑ Canopy Type II ❑ 2efrigeration System � 70-t 00,000 6TU ❑ 100,000 System Fe air/Alteration Fire Dampers ' � Aegisters . �,,,,,,,� �ate Fee $ 3 � $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher lectric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage �isposal Generator ��0-5 KW Fee 5QBB 2/16/88 Zone Accessory Building: ' . Parking Req.IProvided , ELECTRICAL � Transformer ❑ 15-50 KW . ❑ 50+KW Meter LJup ro 700 amps . Meter ❑over 100 amps � Sub Panel . � Morors�0-1 HP01'h-8 . Inc.Solar �9-15 HP 016-75+ Microwave Pole Light Range Standing Sections 5-15 KW Trash Compactor $15 Issue Fee DEVELOPMENTSERVICESREQUIREMENTS: Zoning APProved BY . Building Approved ey � � 72a30 TL FEES $ 3' Z O N I N G R E Q M T S SUMMAF�V OF FEES ' SO BUI DING PERMIT $ �_�_ 'SMIP . $ �_ PLA CHECK $ PERMIT PLUMBING � $ ISSUANCE $ PUIN�CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ � Pf,AN CHECK 50% $ MICROFILM $ � MECHANICAL $ . TOTALFEE $ �� PLAa CHECK 25% $- �CONSTRUCTION AND PLqNNING _' ' � POC SPA ;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=Undrgmd. � 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 Undrgrnd., Test � ,:� 9. Water Pipe-Uniirgrnd. �- 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 Plumbi�g�. � � • � 65. Electrical-Final ' " � �15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring , ' 87. Fencing & Access Approval 17. Rough;Wiring Sign 68. APPROVED FOR PLASTERING � 78. -Rougli.Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough'Heating & Air Conditioning FIRE DEPT. REQUIREMENT . 20.,Rough:FactoryFireplace APPROVALS � Permit# � _ 21. Ducts; in`Structure . 70. Underground Hydro 22. Ducts`-Vpntilating� : 71. ProductPiping�Gas ❑Oil 23. `Gas Pipe-Rough & Tesi 72. Underground Flush , 24.'�Roof Framin�. �, 73. Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26: T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing � 76. Dry Standpipe 28. Lathing $� Siding - , 77. FIXED SYSTEM FINAL _ 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing' . HEALTH DEPT. REQUIREMENT . 31. Plaster Brown Coat ,� 79. FINAL INSPECTION ,_ 32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED ' � 33. Firial�Electric ' � 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 pomesticFinal . . � 42. Backflow preventer � p .• 43. Backflow Irrigation � ' te �ngp8LL10�S ,? � . 44. Landscape Irrigation System y . 45. Sound Attenuation JdtB � 46. HandiraF� Regulations � � � �47. FINALSTRUCTURE&BUILDING . �' � 48.. Special Requirements Completed ', 49. Electric Release to Edisori 50. Gas Release to Southem California Gas Co �✓ 51. CERTIFICATE OF OCCUPANCY • No. Date _, WIt�LIAt•1. 41. JOB ADDAESS � �� GENERAL CONTRAG�TOR �'�eT-Bil]1d@P INSPECTIONS /,� W I DATE FIRE SU6CONTRACTOR BUILDING PERMIT NO. �, �- VALUE $ Ll� 3