HomeMy WebLinkAbout699 19TH ST - Building PermitsAOVlicant to fill in all spaces excapt those witnin heavy DorEer Iines anE.sign all apPropriate tleclantions.
CITY OF COSTA/ M,,ES/A'; CONSTR/�U1,C�-TION PERMIT oGAnnir n�n � TRACT NO. LOT NO. IINIT Nh
Project Address y`�`�1 �. (`I'T I 1 �
Applicant's Mailing ddress V�3t7Y �ZOi1 C7i 9( 7 i3-12f70
Owner's Name�-1 -� Phone� S3� 4'
Addreu �i r �"� yr _ ,
Arch/Eng. License No. —
Addreu --
Con[ractor's NamP -� Phone —
Address (mailin9) �—
City License No. ' � •— �
LICENSED CONTRACTOR DECLARATION '
1 h¢reDy a(firm that 1 am licensetl untler provlsion5 of Cha�tei 9(Commencin9
wilh section �000) o/ ,DlviSion 3 of Ihe Businasz anil Professlons Cotle, antl �
my Iicenze is in /ull torce antl effect. �
LJcense Class - � --Licanse No.
Date - Signature
WORKERS'COMPErySATION OECLARATION
I nereby aftirm that I have a certifitate'o( consent to selftinsure or a cerHficaie
o/ Worken' CompenSy�iOn �Insurance, o� a CerUfletl copy thereot (SeCtion
'800, Lab. G.) '
olicy No. Company
BCertiTieU 6opy Is nereby fvrnishetl.
Certifietl copy is flled with the city Builtling Dlvision.
EXEMPTION FROM WpRKERS' COMPENSATION OECIARATION
(ThiS sectlomneetl no� ba Completetl if [he permk is }or one huntlretl (5100) or
less).
I certlty that in tne p¢r/ormance of Ihe wo�k fOr whicn thi5 plrT�t Is ISsuGtl, 1
shall not emploY any person in any manner so as to become subject to the
Workers' Companution Laws ot California. .
Data Si9nature
'NOTICE: If, aft¢r making this Cecla�ation, you ShOultl become Subject to th¢
Workers• Compensat�on provisions of Ine Labor Cotle, you must forthwith
comply with such p�p��slons or this permil shall be tleematl revoketl.
CONSTRUCTION IENDING AGENCV
1 hereby a/(irm thaf [here is a core[rucNon IenAing agency for the performance
of tne work tor Which this permlt is isiuetl (5ection 3097 Civ. C.)
L,enOer's Name
Lentler's P.Otlress �
pWNER BUILOER bECLARATION - -
i nnrebv aftirm that i am exemot from tha ConVactor's License Law for the
a sian¢E Sta[ement that h¢/ihe IS Iicensetl,pursuant to the
Divislon 3 of tne 6usiness antl vrotesvons wae� or mac na/sne � xe rv�
therefrom anC the basis for the allegetl exemptlon. Any violation of Section
..�031.5 by any applicant for a permit subject5 the applicanl' [o a civil
'�H.9enalty of not mora t�an five huntlretl tlollars (5500).
.::� I, as owner of tne proper[y or my employees witn wa9ez as Iheir sole
"comoensation, will ao the work, ana the structure is not intentletl or ofteretl
for wle (Seclion 7044, Business antl Prolesilonal Cotle: The Contrac[or's "
License 12w aoes not appry to an owner of a oroperry who bullAs or improves
the�¢On. antl who qoes suGh work him5elf/nersel} or througM1 hI5 0� he� own
em0�oyee5, PtoviGed thdt such imp�ovemen[5 a�e not Intentlad o� offeretl tot
sale. If, however, the bulltlin9 or improvement is soltl within one yaar of com-
platlon, the owner W�II have the burtlen of proving he/sne tlitl not bulltl or im-
��Ove fo� tbe purpoS¢ oi sale).
I, as owner of t�e property, am extluslvaly contrac[inq wlth Iicensetl con-
traclors to construct the project (Section �044, Businezs antl Professions Cotle:
The ContractoYs License Law does not apply to an owner ot properry who
bui105 or improves th¢reon, and wh0 cont�act5 br such projact5 wltn a Con-
tractor(sl license pu�zuant to the Contracto�'S Litanse Law). 1 aT aware that
proot o( Lheit Wo�ker'S Compen5ation in5utance ShOultl ba 0/ovitl¢tl to m¢.
❑ I am exempt untler Section B. 6 P. C. for this reason
Date owner�
1❑ere�vi certi/v [hat 1 nave �eatl tb75 appliCation antl s[ate [hat the above
Signature
�lIVBlS' LICCOSC
TVPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ OEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TYPE OF PERMIT LJ GRADING I.J FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELEC7RICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIP710N SO.FT. OCCUPANCV—
CONSTRUCT�ON TVPE VALUATION $
ZONE GRADINGCU.VDS. ACRES_
Ramarks:
Sink
Preventer
Irrigation
Drinking Fountains .
Floor Drains
Floor Sinks
Gas Service Outlets , .
Interceptors
Ki[chen Sink
Lavatories
P-Trap
Roof Orains -
Feinspection.Fee � §75
0
Duct-UnderGround
Duct-Structural �
Duct - Ventitating
Exhaust System ❑ Multiple ❑
Firepl/Fxt. Blt. IC80 #
Heating System & Ducting
Qa � oo,000 eTu O i oo,000 en
Reinspection Fee . � � 515
CMF 0865-46, rev. 30/04 White - Builtling; Canary • qpplicant; Vink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal �
Water Closet
Water Heater
Water Service
Auto-Wash
Isue Fee
iANICAL
Hood or Typel ❑ '
Canopy Typell ❑
Retrigeration System �
❑6100,000 BTU ❑100,000 BTU
System Repair/Alteration
Fire Dampers
Registers
laue Fee
FEES
A.P. #
S Main Buildi
E
T Front
8 Rear
A
C Righc
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryero �Gas ❑Eleci
Fan
F.A.U.
Fixtuies
Device Boxes
S 3 I � � -� � .�
1
Accessory Buildin9:
Parking Req./Provided
Oi30730.;��;
Zon—�
Z
O
- , - N
1
N
G
- R
' ' E
_ Q
M
T
S
ELECTRICAL '
Transformer ❑ 15-50 KW'
❑ 50+KW
' Meter ❑up to 700 amps
Meter ❑over100amps
Sub Panel
Motors O61 HP � i'f, � 8
Inc. Solar �9-15 HP �16-15+
Microwave
Pole Light -
Range '
ispowl ; Standing Sections
❑0.5 KW 05-15 KW Tiash Compactor
Reinspaition Fea $75 laue Fee
FEES '"
T DEVELOPMENTSERVICESREQUIREMENTS:
I 2onin9�APP�oved By
Buildin9 Approved By .
S 3
"�� SUMMARV OF FEES
✓!BUIL'DING PERMIT $ � SMI
M�PLAN CHECK $ P�
��PLUMBWG � $ � AN
` �PLAN CHECK ENERGV
ELECTRICAL GRA IN
PU1N CHECK 50% $ I OF
MECHANICAL $ - OTAL F
PLAN CHECK 25% $
FEES
� S 3 �
—Date
—Date '
_Dat
$
CE $
C.
L $
EE $
�' �CONSTRUCTIONAND•P.LANNING �,:- .� . ' � "-�,� � �:� =' : •,� :,POOLa _.A,. , _.
' APPROVALS Permit:# " - • 'D� IO��Of ' � ,APPROVALS � Permit� '
� • F
: 1..TemporarY Electritll Service or Pole <_ � 52. Pool.& Equipment Location �
�_2.- Soil Pipe•Undrgrnd. ' =; , - , -. 53: Steel-Reinforcement _ � -
:3.'ElecVipl Conduit Utility-Undrgmd. ' - . ' - 54. Forms_ , : ' r ' - . -
.:4..Electrirai Conduit-Undrgrnd. t . . ` � = 55. Electripl Bording � , ' _ .
�5. Steel�Reinforcement '� ` - - - � � `56.'Rough�Plumbing&RreuureTest
6. 'Electrical UFER Grnd. . , � . 57-. APPROVAL TO COVER-GUNITE
, ��7. �Footings , , " • � � � ` 58'. Electrical Gonduit-Undrgrnd.' ��
, i ,8. Fo�undation ' ' . . ' 59�. Gas� Pipe-, 0 �Undrgrnd., Tesi . -
�•9. Water Pipe-Undrgrnd. , �, � � ` 60. � Backwash Lines; P-Trap, O Undrgrnd.
_ �10. Structural Floor System� � � � �� 6L'_ APPROVA�L TO DECK -� .
'�1�1. Property Sewer Line & House Connection � ' 62. Backwash & Receptor-Final
,1�2. Sewer.Cap � - - 63. �Heater & Vent-Fin'al �
93. Roof'Drains � � �. .64. Plumbing System - Final � � ,
� 14. Ro�gh Plumbing . 65. Electrical:Final . - . . " � '
�' � 15...Rough Electrical-Conduit- � - . -- � - - 66: Solar System-Final' " •
'.16. Rough Efectric Wiring � � „ , , } - -� 67: Fencing &"Access ApprovaP , � _.
-�: 17., Rough.Wiring Sign � ��. j � i 68; APPROVED FOR PLASTERING
18. Rough Electrical-T.'Bar Ceiling � - � �� 69. POOL/SPA SYSTEMS FINA� �-
� 19.. Rough�Heating & Air Conditioning . ' FIRE DEPT. REQUIREMENT �
_ I
- � 20.� Rough Factory Fireplace ' , APPROVALS Permit #�
f 21.'Ducts,'in Structure ' . � � � ' '70. Underground Hydro�� ' � �
n �
� 22.,Ducts,Ventilating _ � � '71: ProductPiping�OGas` QOiI � �
: 23. �Gas.Pipe-Rough & Test � � j, ! � �72. Underground Flush�� - �
��,24. Roof Fram,in � �
9 . . . i . 73. Undergrnd. Storage Tank O Gas O Oil
� 25. Roof Sheathing . , ' ;7'4. Overhead Hydro , -. � �� .
26. �T-Bar Ceiling (Structural) �& Monocoat �� � � �75. Dry Chemical i . _ . , ��
-27. -Frame and Flashing � ' 76. Dry Standpipe+ . .
28. Lathirg&Siding � , � ' 77. F,IXEDSYSTEMFINAL
, ' 29.' Insulation � - - ' . � ' 78. F�IRE PREV. F�INAL '
- � 30. Drywall Nailing � � ' � � � � . � � � � HEALTH DEPT. REQUIREME
- , _ � ._,__ . -- .-
-'�37. Plaster Bro�ivn Coat � ' 79: FINAL INSPECTION ''
' 32.-Electrical Power MeterFinal � � � � � i 80� FOOD CERTIFICATE ISSUED '
33. Final Electtic , � . � I i ' i Notes:' , � �
34. F.inal Heating.&.Air Conditioning , . � � � �f .„ s_�
35. Final Gas Pipe,Test ' ' � _ I , ' � � �
36. Hood or Canopy � � - - � � • � � � ' �, _.
37. Final Faaory Fireplace ' � � -� , � � , ,
38. Firial Plumbing � � � , �� ' ' � . ' ' � ' � � , � '
39. Water Service-Final� ' , ' - � , � � ! '
� �
40. Ges Service�Final � � � � ;, � ' . � � . � ' '
r
41. $olar pomesticFinal � � . � . ' , _ , ; _^ . . . '
, � -
42. Backflow Preventer . ' , �� � . � ' � ',
I � �-
43. Backflpw, Irrigatiom-- '-- t �. ' - � � � � � , � ' � ^ � � r i `
44. .Landscape Ir�igation System � { ' ' � ; i � � � i ; ' � . r,
45. Sound Attenuation j - . � � � � � � ' � `
46. Handicap Regulations � ' ' , t ' -- � , � � ' � � � �
47. FI,NAL STRUCTURE & BUILDING �'' i I` i � � �
� ' t ,rt
48. Special Requirements Completed� , � � � � �� j ' � , " � i ! ' • �, c ..
i I
49. Electric Reteas�
50. Gas Release to
51. CERTIFICATE
� , � ,
Date��_
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