HomeMy WebLinkAbout853 19TH ST - Building Permits1
Applicant to till in�all spaces exeept those within heavy Dortler Iines anE sign all appro0�iata Oeclantions.
PERMIT NO. � TRACT NO. LOT NO. UNIT NO.
CiTVOFCOSTA ESA CONSTRI.�CTIONPERMIT P�, `t; A.V.s1E zo�a
Project Address �s3 W• I�I T S%i2EE f 5'
���% WE�TLrFF���Z N•S, TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR E MainBUilding: AcCEssOryBUilding: Z
Applicant's Mailing Address Front
TiCH�+T � �yb-367`j � CONVERSION ❑ DEMOLISH ❑ OTHER T O
Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. 8 Rear N
Address /� /� W�s c-C, fF �r • N� • �/ �-6 L o#i�i A '�
TVPEOFPERMIT GRAOING FOUNDATION STRVCTURAL I C Right N
Arch/Eng. License No. K G
Addre55 ❑ TENANT ❑ ELECTRICAL �PLUMBING ❑ MECHANICAL g� Left R
Contractor's Nam Phone ��o7HER Ping. Ref. # Parking Req./Provided E
PROJECT DESCRIPTION SQ. FT. oCCUaANCv �
Address (mailing) Planning Notes: M
CONSTRUCTIOIV TYPE VALUATION $ T
CilyLicenieNO. ZONE GRADINGCU.VDS. ACRES
LICENSEO CONTRACTOR DECLARATION S'
I h<reby alfirm t�at I am licensetl un0¢r provlsions of Charter 9(commentln9 Remarks: ,
wit� sectlon 7000) o/ Divlsion 3 of the Business antl Professions Cotle, antl
my license is in tull torce antl et�ect. ELECTRICAL FEES
License Class License No.
oate 5i9�ature PLUMBING FEES Automatic Washer Transformer ❑ 75-50 KW
WORKERS'. COMPENSATION DECLARATION Bef Sl�k $hOw2�5 Construction Pole Sub. � 50 + KW
I bereby atfirm tbat 1 have a cerU(iwte of ton5ent to selt-insure or a cerHfiwte �
�= workers' Compensation Insurance, or a certliletl copY thereof (Sectlon Backflow Preventer Servite Sink Cooking Unit Meter ❑up to 100 amps
a?;;.. v`J. l.ab. CJ
-�`�'.:cy No. Company Backflowlrrigation SewerCap Dishwaiher Meter ❑over100amps
4� Cerfitied <opy Iz �ereby furnishetl. Dry¢rs ❑Ges '�ElecVit Sub Pan21
Ce�tifietl copy IS fil¢tl with the city Builtling Dlvislon. 02LhtubS Sewer Connection
Date Appucant Fan �� Motors O61 HP O1 X- 8
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION Clefifief5 $olar ColleCtOfS �
(Th;s section neetl not b¢ cOmpletetl i1 the permit IS tor On¢ huntlretl (E300) or F.A.U.
iess . Dishwasher . Solar Piping � Inc. Solar 9�75 HP �16-15+
I certify that in the per(ormance of the work for which this permk is Issuetl 1 Fixtures `
shall not employ any person in any manner so as to become subject to tf�e Drinking Fountains � Solar Tank i d Microwave
Workers' Com en n Laws ot Calitornia.
Date �- '�' �� �S�9nature ��+�+- a— r Floor Oreins Swimming Pool w/Spa Device Boxes UF Pole Light �
NOTICE: 1f, afte� mdking this tlecla�a you�5houl b<COme su�jecl to t e �UtlEtS % Ran 2
Workers' Compensation provisions of Ihe Labor CoOe, you must forthwith Floor Sinks Urinal 9 '
comply wilh Such p�ovlsion5 or tnis p¢rTit Shall be tleemeC rBVOk¢tl.
CONSTRUCTION LENDING AGENCV GasSerVlCe OutIC[5 Wet2fCloset SwiLChES Slgn
I hereby aifirm that there is a conStruCtlon I¢ntlin9 agency to� the OerformdnC¢
of tne work for wnich this permit is issued (Section 3097 Civ. CJ Interceptors Water Heater Garhage Dispo521 Standing Sections
l.entl¢r's Name
�entler's Amress Kimhen Sink - Water Service 2 Generator �0.5 KW 05-15 KW TraSh COmpactor
OWNER BUILOER DECLARATION �
1 hereby af(irm ihat 1 am exempl (rom the Contractor's Litense l.aw Tor Ihe Lavatories Auto-Wash
following reason (Section 7031.5 Buziness antl Profes5lonal Coae: Any city or
counry which requires a oermit to construct, alter, improve, aemolish or repair P—Trap Laundry Trays -
anY sVucture, priOr to i[5 i55udnce, also r¢qWres lh¢ dpplicant (or SUth permit
to file a siqne0 5[atement that he/she is Iicensetl pursuant lo the provlsions of Roof Drains �
the Contractor's License Law (Chap[er 9(commencing with Sec[lon 7000) of
Division 3 of the Business antl �Professions Cotle) or that he/she is exempt Reinspaction Fe9 $75 ISsue Fea $ 3
thP�efrom and the basiz for (he allegeE ezemption. Any vlolation ot Sectlon '
7 5 by any applicant (or a Oermit subjects tho appllcant f0 a civil
f y ot not more than tive nuntlretl tlonars (E500). DEVELOPMENT SERVICES REQUIREMENTS:
�t� , as owner of the property or my employeez with wages as their sole Rainspection Fee $15 laue Fea $ 3 Zoning Approved By Date
compensa[ion, will tlo the work, antl the struc[ure Is,not intentletl or offeretl � ' �
(or sale (Section �044, Business and vrofessional Cotle: The Contraclor's MECHANICAL FEES Building APProved By Date
License Law tloes not app�Y lo an owner of a property who bulltls or improves �
[�ereon, antl who tloes such work hlmself/herself or through his or her own . ' - Application Issued By Dat �
employees, provitletl that such improvements are not Intentle0 or olferetl for Boiler Hood or Type I ❑ -
sale. If, however, tne builtling or improvement is soltl within one year of com- Canopy Type II ❑ . SUMMARV OF FEES
pletion, the owner will have the ourtlen of proving he/she tlltl not builtl or Im- Duct - Under GrOund . �
prov r tne vurpose ot saie). BUI LDING PERMIT $ SMIP $
az owner o( the oroperty, am ezclusively contracting with IlcenseG con- Duct -Structural Refrigeration System pLAN CHECK $� PERMIT
t�actors [o con5t�uct th¢ p�Oject (SeCtiOn 7044, Business antl P�ofe55iOns Cotle: . . .
The Contractor's License taw does not apply to an owner ot property who Duct - Ven[ilating ❑0-700,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $
builtls or imOroves thereon. antl who Cont�dtts fo� suGh oroi¢Cts wlllt a con- -
tractor(s1 I�cense pursuanc m me Contractors License Law). I am aware tha[ Exhaust SyStem ❑ Multiple ❑ System Repair/Alteration P�N CHECK 25% $ ENERGV P.C. $
proot o( their�Worker's Compensatlon insurance shoultl be provitletl to me. ELECTRICAL $ GRADING $
L7 1 am exempt untler Section B. & P. C. for this reason Firepl/FatL BIL ICBO dk Fire Dampers MICROFILM $
-, / ' PLAN CHECK 50% $
Date '�� Owner Heating System & Ducting Registers MECHANICAL $
I her¢by ce�tify tha[ I hav¢ r¢ this aOP�iCatlOn dntl stal¢ that th¢ above ❑0.100,000 BTU Ot00,0006T � � TOTAL FEE $ tr�
intormation is correct. I agree to comply with all tlty antl wunty ortlinances PLAN CHECK 25% $ �
antl state laws relatin9 [o builtling construction, antl hereby authorize repre-
sentative5 of this city to enter upon tne above-men[ionetl property for
Inspection purposes� � n� i -8'Y9 �
Signature /W ^l �� �Date �
Drivers• LI o 55 9f Reinspection Fee $15 Issue Fee $ 3
01 00025968-000?5968 TC7� q,Up
0865-46, rev. 5/88 White - Builtling; Canary - Applicant; Plnk - Atcountin9: GolOenrotl - Assessor �ATE' �2�Q���i9 TI�F: 11: ]3
CONSTRUCTION AND PLANNING ��� $ �PA
APPROVALS Permit# � Date Inspector AppROVALS Pei. # Date Inspector
7. 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 , i
� 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
l 6� Electrical UFER•Grnd. 57. APPROVAL TO COVER-GUNITE
i
7. Footings 58. Electricai Conduit-Undrgrnd.
8. Foundation •� 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final .
72. Sewer Cap 63. Heater & Vent-Final
73. Roof Drains ' 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit { 66. Solar System-Final
. 16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof �Framing � 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing � - 74: Overhead Hydro � .� �
26. T-Bar Ceiling IStructuraq & 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. Final Electric Notes: � �
34. Final Heating &.Air Conditioning
35. Final Gas Pipe-Test �
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing �i'J �
39. Water Service-Final � �
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer ' -
; 43. Backflow Irrigation ��
� 44. Landscape Irrigation System -
i
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release to Edison . "
50. Gas Release to Southern Califomia GasCo - , �r� •
51. CERTIFICATE OF OCCUPANCY . �,
,
No. Date '