HomeMy WebLinkAbout184 MERRILL PL - Building Permits (3) •Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
CITv 5511FP MIT N TRACT NO. LOT NO .� . ,��
ClSTA DESA CONSTRUCT PERMIT 39-14 U A.P.#
¢ss 10.:' \ . C•.%_ .t
` a "'
. n I S Main Building:. Accessory Building:
'ApplicanYS Mail -A•dress e. w c TYPE OF CONSTRUCTION NEW U ADD H ALTERATION U REPAIR E -• f • I , Z
❑ CONVERSION ❑ DEMOLISH ❑ OTHER - • T Front GI !• 0
•
Owner's Na e \ Ik _�,r. \ Phone ir
v ��` _�� DESCRIPT ON F WORK/USE F BLDG.
N/`a^^J 9 r� B Rear _� 3 DI Lon
N
Address .►....> r�• 8— - J Q rpl.!t �— - A I .
TYPE OF PERMIT ❑ GRADING ❑ FOUNDATIO ❑ STRUCTURAL C Right. 5 A N
ddfess Arch/Eng. License No. K G
Addiess ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S Left =� 51 -- R
Ci;ntractor's Name 0/8 Phone ❑ BOTHER • yam¢ [//� Ping. Ref.# ,� ceiti -_ Parking Req./Provided ,r E
Address(mailing) PROJECT DESCRIPTION SQ. FT. s.A• .1• 17Jc OCCUPANCY R_ ! "l O
CONSTRUCTION TYPE z - VALUATION$ �J Planning Notes: n �}� r/��� mrll�!}�7� M
City License No. T
ZONE GRADING CU.YDS. ACRES LOW/ FOR SPECIAL REOUIREMENTS g,
•
LICE CONTRACTOR DECLARATION �p p �p/' �J/}}
hereby affir I am Iirgnse3 under provisions of Charter 9 (commencing Remarks: TR /A, • f.,'�Z3 sp S.p_ T c�' [41lb4e�
with Section 7000) o 3 of the Business and Professions Code, and
my license is in full force and effe ELECTRICAL FEES
License Class . ense No.
Date • Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW •
WORKERS'COMPENSATION DECLARATION • Bar Sink Showers Construction Pole Sub. 0 50+ KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate
- - -
t....-of Workers' Compensation Insurance, or a certified copy thereof (Sec Ion Cooking Unit Meter ❑up to 100 amps
3800, Lab. C.) Backflow Preventer Service Sink
Polis o. (Md/ ri Company Cl a e_ +F(. , Backf low Irrigation Sewer Cap Dishwasher Meter 04405r100 amps
ertified copy Is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
(� Certif�T/, c d with the city Building Division.. - Bathtubs Sewer Connection
1 Date CL� � Applicant - Fan
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION • Clarifiers Solar-Collectors Motors HP ❑1-%-8
(This section need not be completed if the permit Is for one hundred ($100) orI F.A.U. olar ❑9,15 HP 016-15+
'less). ' Dishwasher Solar.Piping
I certify that In the performance of the work for which this permit is Issued I Fixtures
shall not employ any person im any manner so as to become subject to the Drinking Fountains Solar Tank Microwave -
Workers' Compensation Laws of California,
Date. Signature Floor Drains �-Swimming Pool w/Spa . Device Boxes Pole Light
NOTICE: If,after making this declaration, you should become subject to the Outlets Range
'Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks . Urinal - ..
comply with such provisions or this permit shall be deemed revoked.
'CONSTRUCTION LENDING AGENCYGas Service .Outie Water Closet =.Switches Sign '
I hereby affirm that there is a construction lending agency for the performance
of the work for which this permit Is issued (Section 3097 Civ. C.) Interceptors Water Heater • .Garbage,Disposal Standing-Sections '
Lender's Name •
' Generator 00-5 KW❑5-15 KW Trash Compactor
r Lender's Address - Kitchen Sink' Water Service
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash .
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit,to construct,alter,improve,demolish or repair P—Trap Laundry Tfaye- - '
•
any structure, prior to its issuance, also requires the applicant for such permit
.to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains •
-
the Contractor's License Law (Chapter 9(commencing with Section 7000) of •
Division 3 of the Business and Professions Code) or thathe/she is exempt Reinspection Fee $15 Issue Fee • $ 3
therefrom and the basis for the alleged exemption. Any violation of Section
7031.5 by any•applicant for a permit subjects the applicant to a civil - - '
e alty of not more than five hundred dollars($500). - $ 3 DEVELOPMENT SERVICES REQUIREMENT-S: .� I p,,. Q ¢�
��?Q.�I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee • Zoning Approved By. hji—' �W�' Date `• W
colo pensation, will do the work, and the structure is not intended or-offered -
for sale (Section 7044, Business and Professional Code: The Contractor's - • _ MECHANICAL • FEES Building Approved By Date
License Law does not apply to an owner of a property who builds or improves ��
,thereon, and who does such work himself/herself or through his or her own Hood Of Type ❑ Application Issued By a �- 91 ��� Dat •L�
employees, provided that tush improvements are not intended or offered for ' Boiler •
sale. If, however, the building or improvement is sold within one year of com- Canopy Type I I, 0 • — -SUMMARY OF FEES .
pletion, the owner will have the burden of proving he/She did not build or im- Duct-Under Ground T.
(/`7
prove for the purpose of sale). +BUILDING PERMIT • $ ---� --bG SMIP $ !J T/
nil.. I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK
tractors to construct the project (Section 7044,Business and Professions Code: $ PERMIT
'The Contractor's License Law does not apply to an owner of property who Duct-Ventilating , ❑0-1 0,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $
builds or improves thereon-and who contracts for such oroiects with a con- ENERGY P.C. $
tractor(s) license pursuant to the contractor's License Law). I am aware that Exhaust System 0 Multiple❑ ystem Repair/Alteration PLAN CHECK 25% $
proof of their Worker's Compen tion Insurance , Quid be provided to me, ELECTRICAL $ GRADING $
0 I am exempt „oder Section -y& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers MICROFILM $
(� p (, • PLAN CHECK 50% $
Date -11�p jjg Owner 1 i W Ilk. Heating•System& Ducting . Registers MECHANICAL $ . $ p 41.1-•v
I hereby ocertify that I have-read this applicat 'JI�'. d state that the above • - ❑0-100,000 BTU'0100,000 BTU -- - TOTAL FEE
Informal on is orrect. I agree comply with a and county ordinances _ • PLAN CHECK 25% $
•
and state,laws :lati g to Cul•1V,e construction, and hereby authorize repre- . \
sentatives of t s ,
inspec\y to en 1 pon the above-mentioned proper y
Inspection purps. ' SS
Signature' . a 1 1.1�\ h_. , �_. D- e -
Drivers' License or SS# ' • •
• Reinspection Fee $15 Issue Fee $ 3 •
0865-46,rev.5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 04/28/88 TIIIE: 15:37 .
' ONSTRUCTION.AND PLANNING ` POOL & SRA }i
Date Inspector Date Inspector
PROmpVAorary lSElectrPermiticalSer# APPROVALS Permit#
y 1. Tevice or Pole _ '-' 52. Pool & Equipment Location :%✓
2. Soil Pipe-Undrgrnd. - _- in 53. Steel Reinforcement - ' -.2\
••3.!Electrical Conduit Utility-Undrgrnd, y " - 54. Forms .,...-.2 _ _.$
-1
4'.'Electdicai Condilit-Undrgrnd., / 55.. Electrical Bonding - .14S:;Steel Reinforcement • i.0i(// .4t/ 56. Rough Plumbing & Pressure Test ' '
9
6:.'E(ectrical UFER Grnd. I. 57. APPROVAL TO COVER-GUNITE•
7:•Footiltgs 58. Electrical Conduit-Undrgrnd. =:.-�
8..Fdundation I. . ,/ , 59. Gas Pipe, 0 Undrgrnd., Test 1 ';p
'9.,IWater Pipe-Undrgrnd. 1 60. Backwash Lines, P-Trap, 0 Undrgrnd. `'-
10 'Structu al Floor System 019-10 &N 61. APPROVAL TO DECK F" `
ICl,Property Sewer Line & House Connection 62. Backwash & Receptor-Final i' •',J
12. Seeder Cap 63. Heater & Vent-Final 1.;
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
`b7. Rough Wiring Sign • 68. APPROVED FOR PLASTERING
118. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •
19. Rough..Heating & Air Corldoning FIRE DEPT. REQUIREMENT •
•
. 13. Rough Factory Fireplace te,_. • APPROVALS Permit#
21. Ducts, in Structure 70.
: ) Underground Hydro
22.Ducts, Ventilating '•. '
71. Product Piping 0 Gas 0 Oil i -
23/Gas Pipe-Rough &ATest f- / 72. Underground Flush 7
24�Roof Framing :`''_; ,'r , 73, Undergrnd.Storage Tank 0 Gas ❑Oil /
X25. Roof Sheathin�,�_ If //b/S Per 74i Overhead Hydro - .
26. T-BarCeiling (Structural) & Monocoat l 75. Dry Chemical
27::Frame and Flashing - 76. Dry Standpipe
• -- t
4''-28. Lathing& Siding * ' 77. FIXED SYSTEM FINAL
29. Insdlation --1L„ • ;78. FIRE PREV. FINAL
30. Drywall Nailing %..'., r{l" - HEALTH DEPT. REQUIREMENT
•_-31,-Plaster Brown Coat) -,--. 79. FINAL INSPECTION
32. Electrical Power Mett 1-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric =;:�ji (1;.. - Notes:
MOLD FOR SPECIAL RE
34. Final Heating & Air Conditioning
QUIRLMLN is
•
35. Final Gas Pipe-Test .
sr-36. Hood or Canopy - 7'/"2/ P-9 Di v .6 t'-,r 190-
37. Final Factory Fireplace •
38. Final Plumbing /a/(94, 44c
•
••39. Water Servipce;Final I, _ '
( ,l
40. Gas Service-Firlal i
.41. Solar Domestic-Final' ' f _ _
t
i
42. Backflow Preventer "' / Fill ` /..,_%...,
43. Backflow Irrigation _ ttly ,
44. Landscape al rrigation System / /• - `r +
45. Sound Attenuation - / `
46. Handicap Regulations. 1 f - t •
47. FINALSTRUCTURE 8/1 BUILDING �r/�KSl G 9111 . `'
48. Special Requirements Completed ,///44 Cp
t
/-
ist49. Electric Release-to Edison
/50. Gas Release to Southern California Gas Co . - .' , re. ^,
, 51. CERTIFICATE OF OCCUPANCY1• r ;/
No. Date ii it '-/
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA ME CONS I)Ugi ON PE .MIT PE IT N� TRACT NO. LOT NO. UNIT NO. A P # - - • I Ione .
Project Address /41 Mem z - 1p�/ r 1 S Main Building: Accessory Building:
Applicant's Mailing Address - . . ,, a - 4(/- TYPE OF CONSTRUCTION LJ NEW LI ADD U ALTERATION ❑ REPAIR E Front - - Z
4414r4.-
� C2/— L�9L ❑ CONVERSION 0 DEMOLISH 0 OTHEfj • T O
Owner's Name 9i /q Phone .•VV —• !! DESCRIPTION OF WORK/USE OF BLDG. [� A Rear • N
Address �O� VA �I� 1�j4f
//'' � � C Right _ N
Arch/Eng. Pal Ve- C. t / )-/'• 3-17 TYPE OF PERMIT . U GRADING ❑ OUNDATION U STRUCTURAL '
ri D/` License No. ,/7 /s pyoK' , , G
Address /1/3 'Vv.Ie-ft Cn.4 14/41-• L.6. 5'Ofl 0 TENANT 0 ELECTRICAL PLUMBING MECHANICAL • ' $ • Left R
Contractor's Name-, �• Skei4&f is•'Lek Phone3C.I-0638' 0 OTHER' Ping. Ref. # Parking Req./Provided - E
Address(mailing) ICI 44•✓dN 'el' 9'z4'V PROJECT DESCRIPTION SQ. FT. OCCUPANCY_ Planning Notes: - M
�9 72- CONSTRUCTION TYPE VALUATION$ T
City License No. ZONE GRADING CU.UDS. • ACRES - • 1 S.
LICENSED CONTRACTOR DECLARATION
I hereby,affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 9— 3 ',,—s.yy - • .
with section 7000) of Division 3 of the Business and Professions Code, and .
my license Is In fu for d effect. ELECTRICAL FEES
License Class � i ense N• / a -
Date ' r.- Signature /
PLUMBING I FEES
.���A _ - ! Automatic Washer Transformer 0 15-50 KW - '
WORKER ' COMPENSATION DE 7.RATI•N - Construction Pole Sub. 0 50+ KW ,
I hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink 2 $hbw¢r3 •
N
of workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - - Cooking Unit Meter ❑up to 100 amps "
3800, Lab. C.) b - Dishwasher Meter Dover 100 amps Policy No. Company 4s_-t�+iS'A— Backflow Irrigation Sewer Cap 2,'" p
Certified copy is hereby furnished. ' Dryers ❑Gas '�Eleclric Sub Panel
—
8 Cert f'e cop i 'ed with the City B g e "•n /, Bathtubs r, Sewer Connection Yr— N Date Applicant el -ION D CLAR
�r t Fan
Clarifiers • Solar Collectors / J Motors 00.1 HP 01)S-B •
',-
EXEMPT on 0 WORKERS'd if ATION D n •TION • - __
(Thise .section need not be completed t pe mit for one hundred ($1e. � , 7 F.A.U. Inc.Solar 09-15 HP ❑16-15+ R
less). - Dishwasher, Solar Piping W
I certify that in the erformance oft • •r // .
this permitLI{ Fixtures � � Microwaveshall not emp a person in any n become s / ' Drinking Fountains Solar Tank - -Workers pp �yyd,Laws of Cal' ni - Device BOXes /Date ( Signature Aq/1 . � - �/' • Floor Drains Swimming Pool w/Spa ',7'.,/ Pole Light
NOTI E: aft making this declar-tio-, yo• s ould beco /subject to the - • Outlets ' Range
Workers' omp nsation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal - - - -- --
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION' LENDING AGENCY - / Gas Service. roudels 3 Water Closet '63� sQ Switches Sign
arc
_
•
I hereby affirm that there is a construction lending agency for the performance , V
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors '- Water Heater - r• „ Garbage Disposal Standing Sections
Lender's Name ' _
Lender's Address / Kitchen Sink • "/ Water Service - . • - W Generator ❑45 KW❑5-15 KW Trash Compactor
OWNER BUILDER DECLARATION •
1 hereby affirm that I am exempt from the Contractor's License Law for the S Lavatories, , I 1 / Auto-Wash , . " 1,2 •
following reason (Section 7031.5 Business and Professional Code: Any city or L
county which requires a permit to construct,alter Improve,demolish or repair P-Trap • Laundry Trays
any structure, prior to its issuance, also requires the applicant for such permit
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - -
the Contractor's License Law(Chapter 9 (commencing with Section 7000)of
Division 3 of the Business and Professions Code) or that he/she is exempt - Reinspection Fee 1 $15 Issue Fee $ 3
'therefrom and the basis for the alleged exemption. Any violation of Section 4
7031.5 by any applicant for a permit subjects the• applicant to a civil •
-
enalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: • I
- Reinspection FeeZoning Approved By Date
• I, as owner of the property or my employees with wages as their sole• Pe I $15 Sue Fee
.compensation, will do the work, and the structure is not intended oroffered -
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
License Law does not apply to an owner of a property who builds or improves , IY•••��_ ��
•
•
thereon, and who does such work himself/herself or through his or her own' Boiler Hood or Type I 0 Application Issued By - Date L/
employees, provided that such improvements are not intended or offered for •
sale. If, however, the building or improvement is sold within one year of com- Canopy Type I 0 SUMMARY OF FEES .
pletlon, the owner wilt have the burden of proving he/she did not build or Im- • Duct- Under Ground -
prove for the purpose of sale). - BUILDING PERMIT $ ' SMIP $
LJ I,.as owner of the property, am exclusively Contracting with licensed con-, Duct-Structural . Refrigeration System PLAN CHECK $ . PERMIT
tract orsto construct the project (Section 7044,Business and Professions Code: �,
The Contractor's License Law does not apply to an owner of.property who . Duct-Ventilating 00100,000 BTU:0100,000 BTU PLUMBING $ L�Z� ISSUANCE $� -
'builds or Improves-thereon. and.who contracts for such orolects with a con-
-
tractor(s) license pursuant to toe Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ ' GRADING $
❑ I am'exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $
PLAN CHECK 50% $ �-•
•�s
Date ` Owner Heating System&Ducting Registers MECHANICAL $
I hereby certify that I have read this application •- state that the above 00-100,000 BTU 0100,000 BTL TOTAL FEE $ �2C72
information is - rect. I , ., to comply w,�.^1,p'- and county ordinances PLAN CHECK 25% $
and state la e ting nding const �/ d hereby authorize repre-
sentatives oyhis ci r upo .,cprope-mentioned" rty or ' • -
Inspection p f.os,.. • /4 A".
Signature A� ..v Date Reinspection Fee $15 Issue Fee •S 3
Drivers' L9ense or SS •!
CONSTRUCTION AND PLANNING' POOL & SPA
APPROVALS Permit# Date Inspector APPROVALS . Permit# Date Inspector
,• i
1. Temporary Electrical Service or Pole. �;!'" ..... 52. Pool & Equipment Location - r:
2. Soil PipelUndrgrnd. �• /d,-s�4S/a%" 53. Steel Reinforcement i ��:
'U• ✓ ,/15,0r
3 Electri• cal Cbndui{'Utility-Undrgrnd. �;" 54. Forms
A: Electrical Conduit-Undrgrnd. . ; 55. Electrical Bonding 1f,1
Sr.SteI:Rei{fercement;�- - 56. Rough Plumbing & Pressure Test • ,.-,r .
6: ElScfrical.UFEd: "-a" ' • . �_�- 57. APPROVAL TO COVER-GUNITE
•7:iF t ng; - 111 ,,,..:1;),„... , ..,i 58. Electrical Conduit-Undrgrnd. ,' ') '/
7 iv
8,1dundation ..•> j • �'�•~ • .1 59. Gas Pipe, ID Undrgrnd.,Test ' •
-9. Water Pipe-Undrgrnd. $ 19/24BY &4.1 60. Backwash Lines, P-Trap, 0 Undrgrnd. ;;l•
10. Structural Floor Sysiem ;' '',f, ' ' 61. APPROVAL TO DECK
111. Property Sewer Line'& House Connection d / -, 62. Backwash & Receptor-Final
.4 id/.. • r
12:Seyyerl Ca15 rs ' ""61 ,e & -
._r
.t A, .f� ii 63. Heater Vent-Finalw
13. Roof Drains 2_` ' I .�' / 71 64. Plumbing System - Final i''
14.
•
14. Rough PlumSiZ I/IOf eY' •/ 65. Electrical-Final r
15. Rough Electric2l-Conduit 66. Solar System-Final •
:1,6. 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
1
20. Rough Factory Fireplace 1 APPROVALS Permit#
r
21. Ducts, in Structure t,> 70. Underground Hydro •
22: Ducts, Ventilating ;
/ 71. Prod uci Piping 0 Gas 0 Oil
•237/Gas Pipe-Rough & Test ;V" r t - 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank O Gas O 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 P.. FIXED SYSTEM FINAL
29. Insulation 'T'V 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final ( _ ail 80. FOOD.CFRTIFICATE ISSUED
33. Final Electric c j Notes: 7
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test 0far a
36. Hood or Canopy ' /!(
37. Final Factory Fireplace
38. Final Plumbing /0747a��'��r/
39. Water Service-Final q/f,�/,F9.yy,<� -
40. Gas Service-Final ('r
41. Solar Domestic-Final
42. Backflow Preventer
it
43. Backflow Irrigation ` �+
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Snecial Requirements Completed
49. Electric Release to Edison ' i
1
50. Gas Release to Southern California Gas Co - - -,1
51. CERTIFICATE OF OCCUPANCY
No. _ Date n
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
P RMIT NO. TRACT NO. LOT NO. UNIT
CITY OF COSTA M S,1p �(7`yO1�NSTR UCTI PERMIT 3�� $ A.P.# I Zone
Project Address / '1 f�1�71�CI.rtr_I I LQL� �r r ' S Main Building: Accessory Building:
Applicant's Ma"'i,'^�"J�Addr1esss 17: f`"IQ W• 13 at �-• TVP OF CONSTRUCTION OL! NEW LJ ADD U ALTERATION LI REPAIR
Owner's Na a AJ�1Cln Va TASSFI. Phone ❑ CONVERSION ❑ DEM�/L_ISH ❑ OTHER T Front Q
Address • —1'7`7 I.Vs • 30+'1 /ST TQL�Qr1CC;��- DESCRIPTION OF WORK/USE OF BLDG. , A Rear N
Arch/Eng. License No. TYPE OF PERMIT U GRADING ❑ FOUNDAT ❑ STRUCTURAL I C Right N
Address ((����/' y (('�'� ������jj 0 TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL $ • Left
Contractor's NameOPkDrAS Ficeptacc5 �CNC• Phone 7-�1? 2O3q 0 OTHER Ping. Ref.# Parking Req./Provided E
Address(mailing) 4505 YY1arthc4A11rEivthr LA(,undQle. PROJECT DESCRIPTION SQ. FT. OCCUPANCY Planning Notes: M
^t Q CONSTRUCTION TYPE VALUATION$
City License No. 1,/n%$�� `U21/49� ZONE GRADING CU.YDS. ACRES T
LICENSED CONTRACTOR DECLARATION S.
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: / / n`..t. b. M354g1
with section 7000) of Division 3 of the Business and Professions Code, and - 7 -
my license is In full rce and effect. • ELECTRICAL FEES
Licens s ,O ic¢n e NO.
Date .- ' Signature _ PLUMBING ( FEES Automatic Washer Transformer 0 15-50 KW
�'� WORKERS'COMPENSATION DECLARATION Bar Sink Showers Construction Pole Sub. 050+KW
I hereby affirm that I have a certificate of consent to self-insure or a certificate
1 of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Prev¢ntei• Service Sink / Cooking Unit- Meter ❑up to 100 amps
�0 3800, Lab. C.) b8L tOlD STATE Fund JnS .
Policy No. Company Backflow Irrigation Sewer Cap r;, Dishwasher.' Meter Dover 100 amps
• Certified copy is hereby furnished. - Dryers ❑Gas ❑Electric Sub Panel
r erti 1 oppjS filed with the city B'y',f fymg �� isio Bathtubs • Sewer Connection -"+
rs„
Date 1 9"101 Applicant t_ a `
`•f EXEMPTION FROM WORKERS'COMPENSATIONIECLARATION Clarifiers Solar Collectors f Fan �IOQ#ors❑0-1 HP ❑1Y.-8
(This section need not be completed if the permit is one hundred ($100)or F.A.U. P
less). Dishwasher •. Solar Piping / / Inc.Solar ❑9-15 HP❑16-15+
I certify that in the performance of the work for which this permit is issued I 1 Fixtures r�
shall not employ any person in any manner so as to become subject to the Drinking Fountains• Solar Tank J•• Microwave
Workers' Compensation Laws of California. _ "
Date Signature Floor Drains Xvimming Pool w/Spa R Device Boxes Pole Light
NOTICE:If,after making this declaration,you should become subject to the Outlets Range
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal 9
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Switches Sign
Gas Service Outlets Water Closet 9
I hereby affirm that there Is a construction lending agency for the performance
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors. Water Heater Garbage Disposal Standing Sections
I ender's Name
r' Lender's Address Kitchen Sink Water Service - Generator 00.5 KW 05-15 KW Trash Compactor
• OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays
any structure, prior to its Issuance, also requires the applicant for such permit
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law (Chapter 9(commencing with Section 7000)of
Division-3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3
�" therefrom and the basis for the alleged exemPtion. Any violation of Section -
7031.5 by any applicant for a permit subjects the applicant to a civil
•
esnalty of not more than five hundred dollars($500). . ' DEVELOPMENT SERVICES REQUIREMENTS:
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By Date
compensation, will do the work, and the structure is not intended or-offered
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By
ern Law does not apply to owner if a proPerty or who builds or improves
Data��_
thereon, and who does such work himself/herself or through hisr or her own Hood or Type I ❑ Application Issued By Date.-,/[-// � r-J�•�p
employees, provided that such improvements are not intended or offered for Boiler
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ SUMMARY OF F 5
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). - BUILDING PERMIT $ SMIP $
I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT (f„ ' '
tractors to construct the project (Section 7044,Business and Professions Code: CTS+"
' The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $
builds or imoroves thereon,and who contracts for such projects with a non —
-
tractor(s) license pursuant to we Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $
❑ I am exempt under Section B.& P.C.for this reason / Firepl/Fact.Blt. ICBG'[/�I Fire Dampers 9 1 �> r�
PLAN CHECK 50% $ MICROFILM $
Date Owner I Heating System& Ducting Registers /l3 r
I hereby certify that I have read this application and state that the above ( 0'100,000 BTU 0100,000Br MECHANICAL 75 TOTAL Fir $ �r�
information is correct. I agree to comply with all city and county ordinances / 70 PLAN CHECK 25 $ ',�jr'/ � s VD
and state laws relating to building construction, and hereby authorize repre-
sentatives of this ity• enter upon he above-mentioned property
inspection purpo-•'. 4 -
(Gl( I(•
Signature a . _ems -. Date 1. J K1
Drivers' License or SS 9Q " Reinspection Fee $15 Issue Fee ygf�f 01 00025029-00025029 11-C)-1 33.00
DATE: 01/25/89 TIME: 13:00
0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING • POOL &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 ,
3rElectrical.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. Pootings I 58. Electrical Conduit-Undrgrnd.
8. Foundation 'moi ., 59. Gas Pipe, 0 Undrgrnd., Test
9.-Water Pipe-Undrgrnd. �/ _• - I 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System • 61. APPROVAL TO DECK '
11. .Property Sewer Line & House Connection - -•• 62. Backwash & Receptor-Final '
12. Sewer Cap - 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 e
17.1 Rough Wiring Sign 68. APPROVED FOR PLASTERING
18V;Rough Electrical-T Bar Ceiling( 69. POOL/SPA SYSTEMS FINAL
19.,Rough Heating & Air Conditioning /J/ FIRE DEPT. REQUIREMENT
20`.Rough Factory Fireplace ` ?e APPROVALS Permit#
21v Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71/ Product Piping 0 Gas 0 Oil
23. as Pipe-Rough & Test T. 42. Underground Flush
24. Roof Framing I , 73. Undergrid.Storage Tank 0 Gas D 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
314.-Plaster Brown Coat 79. FINAL INSPECTION 1.
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED -!'t i
33. Final Electric Notes: 1
34. Final Heating& Air Conditioning �� g/89 J S t
35. Final Gas Pipe-Test / ���{
36. Hood or Canopy
37. Final Factory Fireplace 1l/VVP9 #11er
38. Final Plumbing
39. Water Service-Final , 1- /
•
40. Gas Service-Final - `
41. Solar Domestic-Final / - . , r'n
42. Backflow Preventer I f
.-
43. Backflow Irrigation ''
44. .Landscape Irrigation System ,
",„-
45. Sound Attenuationii
"
46. Handicap Regulations •c.�
47. FINAL•STRUCTURE & BUILDING •-
48. Special Requirements Completed ' +
49. Electric Release to Edison -moi it ,i J'
50. Gas Release to Southern California Gas Co '( ( -
51. CERTIFICATE OF OCCUPANCY - ,
r
No. Date ,
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
•
PER NO. TRACT NO._ LOT NO. UNI O.
^ITYOFCOSTA /�I LS`A CO,NytSoTRUCTIONPERMfTQ "�T3b 33� Nw q,p,# Zone
¶rojectAddr
/g7 n9&��MLL Pt // LLJJ S Main Building: Accessory Building:pplicant's Marlinddress .2 / 0(�/sG /�V TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION REPAIR - -wner's Name ,/42-47ra.�4. Phone L75^(099
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front D
DESCRIPTION OF WORK/USE OF BLDG. I A Rear N
Address 11 �1
Arch/Eng. - License No. TYPE OF PERMIT GRADING ❑ FOUNDATION LJ STRUCTURAL C Right G
•
Address . 0 TENANT ELECTRICAL 0 PLUMBING 0 MECHANICAL $ . Left
33
Contractor's Nam 4 ,t �1 P�hon »G 0 OTHER •Ping. Ref.# Parking Req./Provided RE
Address(mailing) LCL"`f� - A-'t A� PROJECT DESCRIPTION SQ. FT. /7�a 9 OCCUPANCY Planning Notes: O
p CONSTRUCTION TYPE VALUATION$ • M
City License NO. _x$2.9 ZONE GRADING CU.YDS. ACRES
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: / •
with section 7000) of Division 3 of the Business and Professions Code, and
my license is in full f e an effect. / /J?2 '8 - '3 S W$1 , /7-1� ELECTRICAL FEES
/C 1Qts`[d w r
License las e License do. Automatic Washer Transformer 0 15.50 KW
Date / - / Signature .✓� PLUMBING I FEES
WORKERS'COMPENSATION DECLARATION Sink Showers Construction Pole Sub. ❑ 50+KW ,
I hereby affirm that I have a certificate of consent to self-Insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit I Meter ❑up to 100 amps Nei
3800, Lab. C}��1,��ys�y�� q 40......0.--no
7n Backflow Preventer Service Sink - / / /y
Policy No- H-The- a-+71 - tet• Company Y 'l$� 'i • Backflow Irrigation Sewer Cap ,�, Clover 100 amps
Dishwasher Meter
Certified copy Is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
Cer[IJJe(j cow?filed with the city g Dl visi n Bathtubs Sewer Connection �'�.
Date `I •rLt D Applicant "� _ Fan Motors ❑0-1 HP ❑1%-8
is EXEMPTION FROM WORKERS'COMPENSATION DECLARATTT���ON Clarifiers _ Solar Collectors a . 1 N
lb
(This section need not be completed if[h¢permit Is for one hundred (5100) or f- F.A.U. J p - Inc.Solar 09-15 HP ❑16-15+
less). Dishwasher Solar Piping J `/`�/`,
I I certify that in the performance of the work for which this permit is Issued, I i .
shall not employ ation son in any manner so as to become subject to the Drinking Fountains Solar Tank - j - Fixtures rri0• Microwave • I sti
Workers' Compensation Laws of California. a[j'''^
I Date Signature Floor Drains Swimming Pool w/Spa j/( Device Boxes sem' Pole Light
NOTICE: If,after making this declaration, you should become subject to the 'TVP'_
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal / Outlets Range • 'Xc
comply with Such provisions or this permit shall be deemed revoked. �!-�
CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet a' Switches Sign I. �T
I hereby affirm that there is a construction lending agency for the performance r
of the work .for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name
Lender's Address _ Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor •
OWNER BUILDER DECLARATION
-
f hereby affirm that Iexempt1.5from the Contractor'sofssioLicense Law for the Lavatories Auto-Wash // y--
I
following f it (Section 7031.5 Business and Professional Code: Any city or
n� c/Jti/�rU,•{/SRI-O(,[��/,
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays U_ ���
.any structure, prior to its Issuance, also requires the applicant for such permit v
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter(Chapter9.(commencing with Section 7000)of •
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for.the alleged exemption. Any violation of Section • Reinspection Fee $15 Issue Fee JA LS s*
7031.5 by any applicant for a permit subjects the applicant to a civil
psnalty of not more than five hundred dollars($500). I DEVELOPMENT SERVICES REQUIREMENTS:
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3
compensation, will do the work, and the structure is not Intended or offered Zoning Approved By Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By
License Law does not apply to an owner of a property who builds or improves --�/ /l�� Date e
thereon, and who does such work himself/herself or through his or her own Boiler Hood or .Type IApplication Issued Byt /JL Date // �/
employees, provided that such Improvements are not Intended or offered foryp 0 VVY
sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 .
pletidn, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground SUMMARY OF FEES
grove for the purpose of sale). BUILDING PERMIT $ SMIP $
U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK
tractors to construct the prosect (Section 7044,Business and Professions Code: ' $ PERMIT
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU
builds or improves thereon. and who contracts for such oroiects with a con- PLUMBING $ ISSUANCE $
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ � ENERGY P.C. $
proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ 7Dp./7� GRADING $
❑ I am exempt under Section B-& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers _
Date Owner Heating System& Ducting Registers PLAN CHECK 50% $ MICROFILM $
•
I hereby certify 'at I have read this application and state that the above
❑O-100,000 BTU 0100,000 BTL.'— MECHANICAL $ TOTAL FEE $ 19-q-5
Information is F• r: t. I agree to com ly with all city a 'ordinances PLAN CHECK 25% $
and state laws r lat • to build g struction, reby authorize repre-
sentatives of t 5I' to ant, on the abo entioned property for
Inspection purp• est _ _
Signature Dale s/al-86 01 00020142-00020142 TOT 78.95
Drivers' License Or SS#
Reinspection Fee $15 Issue Fee $ 3 DATE: 11/21/88 TIME: 15:27
0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING r' POOL& SPA
l
APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole , 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 1 53. Steel Reinforcement _ _
3. ElectiicalConduit:UOity-Undrgrnd, /0 c , 54. Forms -
41 Electrical Conduit-Undrgrnd. - -? 55. Electrical Bonding
5' Stern Reinforcement i 56. Rough Plumbing & Pressure Test i•)
6. Elctr'ical UFER Grr'd.i57. APPROVAL TO COVER-GUNITE
0 :
7.'Footings 58. Electrical Conduit-Undrgrnd. -•
8.'Fouridation ' I • ,i 59. Gas Pipe, 0 Undrgrnd.,Test
9.•lNater Pipe-Undrgrnd. . 60. Backwash Lines,P-Trap, 0 Undrgrnd. /i .:
10. Structural Floor System ' . ' ' 61. APPROVAL TO DECK
11:'property Sewer Line'& House Connection IT, 62. Backwash & Receptor-Fina •
l
•12:•SewerlCap ' ' "1 ,' 63. Heater & Vent-Final •
I
13. Roof Drains . II, 64. Plumbing System - Final •
14. RougAA Plumbing - 65. Electrical-Final r'
. 15. Rough Electrical-Conduit 66. Solar System-Final -
16. Rough Electric Wiring t -11 ,57 tick- 67. Fencing & Access Approval
1971. Rough Wiring Sign 68. APPROVED FOR PLASTERING
148; Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL _
19) Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
201 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
14. Roof Framing �'' 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing I 74. Overhead Hydro
_r
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
J/J'
33. Final Electric Notes:
34. Final Heating& Air Conditioning I , ,_<
35. Final Gas Pipe-Test
36. Hood or.Canopy .4•"1
37. Final Factory Fireplace
38. Final Plumbing ) \.• moi.'")
39. Water Service-Finalr I , !%
s
40. Gas Service-Final c' ,
41. Solar Domestic-Final ...,\_. : •`
42. Backflow Preventer • _ . �'-,
43. Backflow Irrigation `---21
44. •Laridscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations '
47. FINAL STRUCTURE & BUILDING =�r•
48. Special Requirements Completed 11
1
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co „ :41
51. CERTIFICATE OF OCCUPANCY .- ) s"•) - ....-/' ';v
No. Date ;J ' ,; :-11 (
/i A