The URL can be used to link to this page

Home My WebLink About730 19TH ST - Building Permits- � . \ �I � CITV OF COSTA Project Address � .ApplicanYs Mailin� OeOner's Name � Address % -� Arch/Eng. Address Contrector's Nam� Address (mailingl � .Ciry License No. � LICENSED CONT� Phereby af(i�m th¢ with. section 7000; mY license is i �fu1j ADP��ant to till in all soaees exceo� those witnin heavy borAer Iines anO.zign alt aoo/oDriate aeelarations � CONSTRUCTrI�N PERMIT D W . 19 � S.T 4CTOR DECLARATION - 1 am licensetl untler prOvision5 0( Charter 9(commencing� of oivision 3 ot the BuSiness antl Professions Cotle, antl orce antl etiect. . . _ _ .., .. WORKERS' COMPENSATION DECLARA�JON ✓%_ ''+ereby atfirm [hdt I have a certificate of consent to self-insure or a certificate Workers' Compensation Insurance, or a certifietl copy tnereof (Sectlon J0, lab. q1 p/� �/1/� �A 'J Gofi� No.� /C�� s04J(/�`TComPanYf�L 1 NA C/�.S�l.. �: L� CerJtiyt�ietl wpy is hereby'turnishetl. j ✓" D�ate/(Jied�oP�wAPOhcn1tYB' 9Divi�/�1�) � / � /f � EXEMPTION FRqM WORKERS' COMPENSATY N DECL TION (This section-neetl not be completetl i( the p¢rmi[ is Por one huntlretl ($100) Or less). I certify that in tq¢ p¢rfo�manc¢ ot the work for which thi5 perm�t is i55uetl ;I snail not employ any'person in any manner so as to become subject to t�ie Workers' Compengation Laws ot Califomia. Date Si9nature NOTICE: If, after making this tleclaration, you should become subject to the Worke�s' Comp¢n5ation provisions of the L,abor Cotle, you mu5t fo�thwith comply witn suCh provisions or tnis pe�mit shall be de¢metl revoketl. CONSTRUCTION LENDING AGENCV • I hereby affi�m thdt there is a conztruction I¢ptling agency tor the pe�tormance of the work for whicn this permit is ,issued (Section 309� Civ. C.) Lentler's Name Lentle/'s Atltlress � OWNER BUILDER DECLARATION ' I he�eby aftirm that I� am exempt f�om the Contractor'S Lic¢nse Law to� the tollowing reason (5¢ction 7031.5 Business antl Professional Cotle: Any city or county whicM1 requires a permit to const�uct, alter, improve, tlemolish or �epair any structure, prior to its issuance, also requires tne applicant tor such permit to file a signetl s[atement thal he/5M1e is licensetl pursuant to Ihe provisions of the Contiactor's U�ense Law (Chapter 9(commencing with SecHon �000) of Division 3 of th¢ Business antl Protessions Cotle) or that he/she is exempt ' -efrom antl the basis for the allegetl exemption. Any violation of Section LS by,any applicant fo� a Pe�mit 5ubject5 [be applicant to a civil �Ity of not mOre tnan five huntlretl tlollars ($500). LJ 1, as owner Of the proper[y or my employees with wa9es as their sole cortipensation, will tlo the work, antl the structure is not intendetl or ofierea for sale (Sec[ion 7044, Business and Protessional Gotle: The Contractor'S License Law doe; not apply to an owner ot a property who bulltls or improves thereon, antl wh0 tloes such work himzelf/herselt or tbrouqh hi5 or her own employee5, Provitled that such imp�ovements a�e nOt intentletl o� otferetl tor sal¢. If, howevet, �he builtlin9 0� improvertient is soltl within One yea� ot corn- pletloq the own@r will have tne burtlen o( proving he/she aitl not builtl or im- plOve to� the Ourpose of sale). � ❑ I, as owner oi the property, am exclusivety contracting with licensetl con- [ractors to mnstruct Ihe pfOjCCI I($2C�10l1 JO44. B1151f1055 dllG PYOiC5510p5 COtlC: The- Contractor's License Law tloes not apply to an owner ot property who "builtls or improves thereon, antl who contracts for such�projec[s with a con- tractor(s} license pursuant�to the Contractor'S License Law). I am aware that proof of thelr Worker's Compensation insurance shoultl be provitletl fo me. ❑ I am ex¢mpt 4ntler Section B. & P. C. for thk rea5on �ate Owner I he�eby certity that�l-have rea� Info�mation is Conect. 1 agree to antl state laws r@lating to builtlir 5¢ntatives of [his� city [o enter Insoection pu�rpf�q5. �J Signature gf!�-^^��i(_Y.�! this apD��cation and-state�that the above >mply with all city antl county ortlinances c structlon, antl heteby authorize reore- n 2 abOva-mentioned O/operty fo� oate �0^7— � 5 ��,,,�2.0�,� � I ....... .._ I -- - I .,,.,. ,..,. TYPEOFCONSTRUCTION NEW �ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPEOFPERMIT GRADING�� FOUNDATION STRUCTURAL O TENANT ❑ EIECTRICAL LLTPLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.VDS. ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Floor Drains Floor Sinks . . Gas Service Outlets � Intercep[ors Kitchen Sink Lavatories ' � P—Trap , Roof Drains � Reinspection Fee $15 Boiler Duct-UnderGround Duct - $LfuCtUral Duct - Ventilating Exhaust System ❑ Multiple ❑ Pirepl/Fact. BIL ICBO # A Heating System & Ducting ❑ 0.100,000 BTU O 100,000 BT Reinspection Fee I $is CMF 0865-46, rev. ]0/84 White - Builtling; Canary ',APPlicant; Pink - qccountlng; Goltlenrotl - qssessor $hOwers - Service Sink - Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee Hood or Typel Canopy Typell Refrigeretion System � ❑0-100,000 BTU ❑100,000 BTU System Repair/Alteration Fire Dampers Registers Iss�e Fee FEES A.P. # S Main Building: E T Front B Rear A C Right g Left Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit . Dishwasher • Dryers ❑Gas -❑Elec Fan F.A.U. Fixtures Device Boxes O utlets Switches Garba9e Disposal Generetor �0.5 KW [ Ifi60 10/07/05 �� Zone Accessory Building: Parking ReqJProvided . � 1 f sOC; ;�,t� -ELECTRICAL - ' - ' : FEES Transformer ❑ 15-50 KW � � ❑ 50+KW 5-75 KW Meter LJup to 100 amps � Meter ❑over100amps Sub Panel Moto�s O0.1 NP 01'/: - 8 Inc.Solar 09-15 HP �16-15+ Microwave - Pole Light � � Range Sign ; Standing Sections Trash Compactor � Z O N I N G R E Q M T S $ 3 I �- Reinspection Fee $15 laue Fee $ 3 FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Appliption Issued By_ i Date� SUMMARY OF FEES BUILDING PERMIT $ SMIP� $ PLAN CHECK $ PERMIT PLUMBING � $ � � ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ � ELECTRICAL $ i �GRADING $ � PLANCHECK 50% $� MICROFILM� $ MECHANICAL $' � TOTALFEE $ I I $ 3 PLAN CHECK 25% $ c� Id�l°f CONSTRUCTION AND PLANNING POOL p� SPA " APPRUVALS Permit# Date �Inspector qppROVALS Pa. ,t# ' Date Inspector "1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � � 2. �Soil Pipe; Undrgrnd. � � 53. Steel Reinforcement � 3.. Electrical Conduit Utility-Undrgrnd. � 54. Forms . . . � ' �4..Electrical Conduit-Undrgrnd. . 55. Electrical Bonding 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test � '6.'ElectricalUFERGrnd. 57. APPROVALTOCOVER-GUNITE ' � 7. Footings. • , �� 58. Electrical Conduit-Undrgmd. � 8. Foundation .,. � , '� 59. Gas Pipe, O Undrgrnd., Test ' 9:'Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, � Undrgrnd. :t.. �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. Rdof Drains ' � 64. Plumbing SYstem - Final 14. Rough Plumbing �� /�� i 65. Electrical-Final , ' 15. Rough Electrical-Conduit 66. Solar System-Final. _, . i6. Rough Electric Wiring 67. Fencing & Access Approval � ,�17" Rough Wiring Sign , . 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground HYdro " 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil • ' 23. Gas Pipe�Rough & Test � 72. Underground Flush � 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil � 25. Roof Sheathing 74. Overhead Hydro ' 26. T-Bar Ceiling (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 � L. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: . � 34. Final Heating.& Air Conditioning � ' - � � - 35. Final Gas Pipe-Test _ 36. Hood or Canopy � , ' � - 37. Final Factory Fireplace � `� 38. Final Plumbing , � {y� p � �f C/[��7 �. ' 39. Water Service: Final � 40. Gas Service-Final 41. Solar pomestic-Final ` 42. Backflow Preventer " � 43. Backflow Irrigation . . 44. �Landscape Irrigation System � � � . ' ' 45. Sound Attenuation 46. Handicap Regulations _ � ' � 47. FINAL STRUCTURE & BUILDING � ' � 48. Special Requirements Completed . -. � 49. Electric Release to�Edison � � 50. Gas Release to Southern California Gas Co � ' ,�� , 51. CERTIFICATE�OF, OCCUPANCY , , No. Date - � . � �