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Home My WebLink About864 19TH ST - Building Permits, L / 9 q�t� a�a3� �o��i 't6��t9 St� 31 irsz ��rK sr:�� 'vla' �—a—�s� k_3_�b, � 9-10 —�6 10- �ff - 7�t 1-�;-&1 . . _ sd, 9 � i � 960- Completed 2es. �� $10,384.; 36230- o-1e-75 aaa :ar,.r�� «"z - SecL-ooms 12�213• i ; 40541 - 5-6-76 pdd to Ccm'1.;,Hldg. 2,400. , � � 48849�C•IS'7`� Blockwall 1100.00 S1I31 �'` N��lec. Proj. Sign 500_ - �)�\ . _ 0 \ �p , B-27111 �/ �9/�� _ � � -�Alter. Lot#396 � � P2723; , ,�� ?7UMBING � � 1 �87si� � �f �a�i�i . �'/31��7 ` -- -- � z�ss�� S��/e� az�lii /1(1�P�' � -- - - . � _M2789�� ( ��3/�� B 2 7111 � � �30�7�—� ,i /.3.0/87 a � 'L ��esta''Mesa � - g Department ~-'—`- �APP1:iCATION FOR�r�rc�r , N1 EAST 20th STREET ,, � B U I L D iL N G \' F.nRTA MFRA_ CA1 IFORNIA `T� • . , .T L . ,_ " .. Y . ' ' L ..� . �11`�b�♦ . I,.�� , .��' � � . � T` ' . . . � " " ) - i � � � 1 . . � � � � . . . - , — • 1 � J : _ . ♦ . " ' ' ' � � ' ` ` - .\ � �! '`� +t � � t\ 1 \ . ' � _ ,.C.� � � �. �i �� ...�'� i. . • I,` ' • � 1G�i � � � � � "L:� �' .. e`oe:_ .��) ; �� .�.•i.�o.:..1 . . � .. ' "'-dL_ . �...� .. ' . , C ... .p.PJ' ' � , .•O)�i .�.IY' �':1�u .. . ' - �.�JR . I � � _� � • �` . ' ' .) }'- -.�'__ _..G.._�� ...��'.`�' .�._. .�.i ' rLVl rLlil�l . • � .i , Show Iocation and distances from " - � - ' - � property line and between buildings. ,,, � ..� ' � � ' - � ; _.. . � • � �.. _ � ,�..._ . . _ " '_ _ . _ ' __ '_ . _ ._ � � icn.' _ � . . . � ' � , n � . � ��t:� _ . 1 . . . . _. � � � ... . ' ' '�' ' ' . . -._ . .. . - -- -• . " -- ' � _ _ . . _ _ _ _ .. , , _. . - ,. �i � '. .. �: — ��. � .. . � �: �' ' '. .. � . . . � � . - . . , � . . . - , v. r . , . _. _ .,. . . � r. . f . , i , � ` `� , - J - _' ` - � � ' ALa. G( fli w a� tiZ 2Q O f' am J ) J f/� � q J U cn q � W ? o� � W q0( �' 2 J GZ CON r 2 T QD�R W o ��T y � � STATE O UC.No S�Z E �F �OT � Z vQ �wNER Mq��, c�rv .. � � 'o�T B� �zpApBU/l0l v62�Q C�Slq C"SAF�,.. F��'Qp.o/i�an MESq �i• . t to Fi//in %%4J,�\ � � a�� ti � \ 1 / US ..�ryG �`� ' �� OF Q e �F BU��Oj R ��Ms F�� _ NG AN ��RK o� gE F Z � � ��N � �.��e�y �� 75-- �'a7n � 7—N. APP I ,�,' .: DO S�`- RE� ��CAT/ Sz'�': . �� P�., a.P, ��oey oNi,SEe�,o��NGPERMIT ..::Z� 36 i'r''� C. ND �OkYOryCODa. � j� hereb O� � �' '�W/NB�I r.` Vq k R v% np/Pe S�ep � tl nlp T��et � haVa I � �.P � ? ma S�ate ��n �ro b�ildi ° is correct a tha Seb� °artif dli orn7a,n °�men�yo�Otion�e/avfeali�orion any R�vEO aheP[e �y O! Cal' onat � em kme��s oT shal/ n0l plV W( h �' SrP� Pro B Sj� a C�d eSPrp �;^n T95 q e P��IB g pO4a �� ec,On I N,5 0� �O� � Parm�h'a o) I • Di tston lc �heSru�l� �orcCeda• Oivis4�de� � a A��horizay '"Z��2 o/Califp nla,e j� r�� TNE SQ. Apant �^ en rHFp 'LipUry. 2Pc_ 4� �A��qTUR�F O/y $/� �j.� �h 2p'�E A �� V'y�UE ii A�' Al FT' \ • C�� N g OqTE B��GS 3 �R��ED :3_a �-�3 � C \ � i � ,N TAk �ER SH�NG N P �VAT/ �P iT FEE ERM? FEE �NIYA o S '� ¢ HE�K S rv �S� J E � m ��- o` �� , ' ' �, �' - � COSTA MESA BUILDf1GG-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDING_� �/ /i)/� i�� ADDRESS (d !.t/ J OWNER C�� / /c�G L/rt�O MAIL TEL. CITV NO. CONS7RUCTION LENDER BRANCH ADDRESS ARCHITECT � TEL. CONTRACTOR ADDRESS TEL. CITV NO. $TATE CITY LIC. NO. . LIC. NO. SIZE NO.OF BLOGS. OF LOT I NOW ON LOT VSE OF EXISTING BLOG. SIZE OF NO. OF NEWB�DG. FOOMS STORIE: EXTERIOR WALL FOOF COVERING COVERING USE OF BUILDING AND WORK TO 8E PERFORMED REqE)V�D�' vV �� — A.P. NO. BUILDING � ADDRESS G TRACT ��, 3n-7;P°'°00 'v9'i �k-•u�53.00 �N FOR BUILDING PERMIT OATERECENED DA EI I . /� — L 20NE NO.OF PIAN$ YAROS APPROV ED REAR FT DISTANCE BET. MAIN BLDCS. VAR. # C.V.P.9W APPflOVED I hereby ecknowlodge tha[ I heve reetl [his application antl state thac the above information is corract nntl aprae xo camply with nII laws regulating builtlinB constr�ction, untl I shall not amploy eny Oerwn In violntlon of tha workmon's compansatian laws of Ma State of Calitornia. I hereby cortlfy tho[ I am properly Ilcensetl as a conbactor untlar SQ. F the Steta ot Celitornia Business antl Protasslons Cotle, Divislcn 3, THE AMOUNT Chepter 9, antl thoc such licenses ara In full force end aHoct, or I THE PURPO6E C em eKempt from lFe provisions of tho Stam of Calltornia Buslnass antl ProfessiOne Coue, Division 9, Cheptar 9. VALUATION Slpnoture of � Permittee 5 Authorixntl Apont � L7RSAW$ �� 'E / GROU Z DATE �/O� USE OF NEW BVILDING VARDSAPPROVED BET TOTAL FT. & m W 0 VALUATION IS FOR ^ A PERMIT FEE ONLV: ¢ E S — � J K 5 E �•4 % u , - ' ' - _ 4t��4:t; COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applican[ to Fill iu Comple[ely — Use Ink Only BUIIDING f/� A � � �n.�j �� F�+ 7. a a y � T F G W F �a O ..1 Q � r .� a w 4 O CG o� z W � 3 OWNER CITY /��L CANSTRULTION A TEL. NO. � T Qe�� cr �e�_�� r��, FOR��TRUCTURAL�I RE � A.P. NO. BUILDING ADDRESS a �3i TRACT ADORESS TEL. CITV NO. STATE CITY LIC. NO. LIC. NO. SIZE �7 NO.OFBLOGS. / OF LOT / O /� �✓2 � NOW ON LOT USE OF EXISTING BLOG. Separate permits are required for elec[ric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED L FIRE ZONE APPROVED NE NO.OF PLANS VARDSAPPPOVED VAR. qW C.U.P. q 6E7 i9� E OF NEW ILDIN _ VARDSAPPROVED & I haroby 9cknowletlpe that I have raetl tNs epplication ontl rtata '^ � that tho obova Intormation is correct antl agrea io comply wlih m all laws reBulating bulltlin8 concvuction, ontl I shall not employ � nny pareo� �� Ioletion of the workman's compensation laws of m tho State of Colifornle. � OO I hereby cartify thet I am properly licensetl es a conttactor untlar SQ. FT. tmv tho Stata of Celiforn(a Business end Professions Cotla, Dlvlsion 3, THE AMOUNT SHOWN UNDER VALUATION I FOR m Chapter 9� entl t�at such Iieenses era in full forca antl effnct, or I THE PURPp$E OF ESTABLISHING A PERMIT FE NLV: � em axempt from t�e visions ot xhe Stete of Callfornia Business VALUATION PERMIT FEE 5 a antl Profess�ons Co a, vision 3, Chapter 9. • 0 in � m Slpne[are Of PLAN CHECK E �^ � /f o Parmittoe _ �� 5 Z O� TAX 5� �y � � U Authorliotl ABo�i TOTAL PAID 5 F C a ¢ � y 2 F ' x 3724 9/26/79 17.01 COSTA MESA BUILDING-SAFETY DEPARTMENT ApPLI T701V*FOR STRdJ�T4?RAL PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 REC PERMIT *jp 48849 For Applicant to Fill in Completely — Use Ink Only 1�� BU�LDING -.��} A.P. NO. �(S� �IBZ � ZI ADDRESS OWNEROR BUILDING AIL[ � TENANT � ADDRE55 �bT C � MAILING UNIT OR ADDRE55 SPACE NO. TEL. TR.N i / Z LOT 396 B�K. CITV NO. ? CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER BRANCH j� OWNER G . ADDflESS - VALUE ARCHITECT TEL. USE � ��J � OR ENGINEER ADDRESS ZONE R�� TVPE GROUP APPROVED i/ � CONTRACTOR ��,(J' N' E2 y ��G(l BY DATE c.�o A�DFESS G ' pLOC.J� W/4LL TEL. CITV NO. STATE CITV APPROVED SETBACKS LIC. NO. LIC. NO. S12E NO.OF BLDGS. (FROM GL STREET) OF LOT � g X /QQ NOW ON LOT � ROM F--' useoF r�NF TRkr1r?i�.N� EXI571NG BLDG. FR�`l �fEr. —,f.ts� �qvn p.f Separate permits are required for L SIDE FT. electric, plumbing and heating work. '� REAR FT. � USE OF BVILDING AND WOFiK TO BE PERFORMED P�qNNING ACTION �1✓"'tC� , �'1PcL--L� DATE «� APPROVED APPROVED�I�� 9_2G--7 9 r� I hareby acknowletlpe that I heve reetl thle epplicetlon and atata � that the above Information ia correct antl epree to comply wixh ell laws regulating builtling constructlon, entl I shall not employ � any varwn in vlolatlon of the workmen's compansetion lews oi � the Stata of Californla. I hereby certify that 1 am properly Ilcensetl aa a contractor untler SQ. FT. � She State of Celifornia Businezs antl Prafasslona Cotle, Dlvision 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR i Chaptar 9, end thet such licanses ere in tull force antl ef7ect, or I THE PURPOSE OF ESTABLISMING A PERMIT F ONLV: am axampt from the provislons of theStata of California Businass VALUATION PERMIT FEE E end Professions Cotla, Divi on 3, C eo�ar 9. . � 0 � Slpnaiura of I�fe� OO PLAN CHECK S � Parm�fttee $ ��jy� � O i v 1.� �' TAX E Authorized Agant Date � TOTAL PAID S 7 City of Costa Mesa DevebPmer,tSrvices L^epartment Buildingpafety Division 7. O. Bpx 1200 Costa Mssa, Califomia CERTIFICATE OF OCCUPANCY No. OO!��3 The Building located at 8h[l Glaat 19hh Atront has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group ;1 /-�7 Occupancy. UseofBuilding Offica/R�aiAanaial Legal Description 47�-57 J-71 (See reoerse side for Metes and Boundsl Building Permit No B27111. H3017Electrical Permit No. F�751'i Plumbing Permit No. P27236 Mechanical Permit No. M27894, M27657 Number of apartments and/or guest rooms 'SSUED TO: 1ou Ch�n Cheng 864 W. 196h Street Costa� Mesa, CA 92627 BuildingOfficial William T. Ho�arc� by � _� Da[e December 1, 19A7 This Certificate of Occupancy SHqLL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White-Owner; Canary - Numerical File; Pink - Bldg. Permit File CFT Y• O F. COST Project Address ON PERMIT S vSiR R�OuwT �� ADP��cant to till in all spaces exeept t�ose within neavr bortler Ilnas ana sign all aooroo/�ata aeelarations. PERMI�,�9O. TRACT NO. LOT NO. UNIT N0. /� ,� 7� 3G, l`l i'i 3Q� Owner's Name v�t v c�c. w v Phone �Address a��a� U.i�ST �T1e S� CCS\ A ��5 � ArchlEng. Licen:e No. Address � J � oG�6 � Contrector's Nam �"� Phone�Z'£'� ��5� Addressir::^;,;^�I�C�I.j� V`Nt i1.�0 �'vWA�I:`'� City License No. �Q��%� LICENSED CONTRACTOR DECLARAT�ON 1 hereby afiirm that I am licensetl untler Provision5 of Char[er 9(commencin9 wi[h section 7000) ot Dlvision 3 Of'the Business antl PrOte55ion5 Cotle, antl my license Is In II force ana eftect. l.ice�i�Class q�� License No. �V�4�• Date ��-i�a..� Signature ' WORKERS' COMPENSATION DECLARATIOSP I hereby affirm tnat I have a certifica[e of consent to self•Insure or a tertificate of Workers' Compensation Insurante, or a,certifiatl copy thereof (Section 3a00, �ab. CJ Policy No. Company BCertifietl <opY i5 hereby furnl5hetl. Certifietl copY ls filetl wit� the city Builtlin9 Divislon. Date Applicant EXEMPTION FRQM WORKERS' COMPENSATION DECLARATION (This 5ecliOn nGetl not be cOmpletetl if the Pe(mit is fo� On¢ huntlretl ($300j or less). . I certity that in the performance of the work tor wnich thls perm�t Is issuetl, I shall not employ any person'in any manner-,so as to become subject to the Worker ,� ansati n ws o( Cali(Om a' A� • O�' Date' Signature NOTICE: I(, attar ma ing this tleclaration, you�sh�IC become su t to the Workers' COmp6�satlon provi5ion5 of the Labor Cotle, you must forthwith comply wiln sNch p�ovisions Or thi5 Pe�mit shall b¢ tleemeC revoketl. CONSTRVCTION LENDING AGENCV I nereby aHlrm that tnere Is a constructlon lentling agency for the performance of the work for which this permit is issuetl (Saction 3097 Civ. C.) Lentler's Name . LentleYs�AtlOre55 - - OWNER BUIL�ER UECLARATION '• I hereby aHirm that I am exempt from the Contraclor'S License Law tor [he following reasoq (�ction 7031.5 Business antl Professlonal Cotle: Any dty or munly whlGh �BQuires a p¢rmit t0 ConSlruct, alter, improve, tlemoliSh or repair any s(ruc[ure, prior to its issuance, also tequires the applicant for such permit to fiie a signcU statement tnat he/she Is Ilcensetl pursuant to tne provisions of che Contracror's LicenSe Law (Chapter 9(commencinq with Sectio� 7000) ot Division 3 0! t�e Business antl Professions Cotle) or Ihat he/she is exempt therefrom antl.the basis for the allegetl ezemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a clvil �enalty of no[ roore than hve,huntlretl tlollars ($500). I, as owne� of the propl�ly o� my employ¢!5 with wa9e5 LS their Sol¢ tompenSatloll, W�� tlo tlle wofk, antl the stNctufa Is nOt intentleU of otfer¢tl for sale (Sec[ion 7044, Business antl Pro�essional Cotle: The Contrattor'S License Law tloes not apply to an owner oi a properry wno bullas or improves theieon, antl wpo tloes such wo�k him5elfJne�selt o� tlu0ugh his or he� own employees, O�oVidetl that such improvements are not intentletl or ofteretl tor wle. It, howOveL [he bullding or improvement is soltl within One y¢ar Of Com- pletion, tno owi�er will have the burtlen oi proving he/she aIG not bulltl or im- prOve for tne purpose of sale). ❑ I, as owner 0< <he property, am exclusively contratting with Ilcensetl con- tractors to construct Ihe projecc �Section �044, Business antl Protesslons Cotle: lThe Contractor'S License Law oes nOt apply to an Owner ot pfoper[y who i builtls o� Impro�e5 Ihereon, antl who co�Vacts fo� such project5 wlt� a mn- Itractor(s ucensa pursuant to the Contractor's License �aw). I am aware tnat proof o� their Worker's Compensatlon insurance shoultl be provitletl ro me. I �]: � am ¢xempt untler Section B. & P. C. toY thi5 reason �� Date Owner � • 1 hereby certlty that I have reatl tbis applicatwn antl state tha[ ihe above intormation Is correct. I agree to tomply with all clty antl munty ortlinances antl itate laws relating to builtlinq conSVuction, antl hereby authorize repre- sentatives o( �s city to enter upon the above-mentlonetl property for inspectlon pur es. siqnature `� Oi� oate�-CEB ��Qi� Drivers' Llcense or SS �_��_ � �' �+ TYPE OF CONSTRUCTION LJ NEW I.J ADD QL ALTERATION LI REPP.I R 0 CONVERSION ❑ DEMOLISH ❑ OT R DESCRIPTION OF WORK/USE OF BLDG. �`>`OI.iJCL � TVPE Of PERMIT LJ GRA�ING L1 FOUNOATION LJ STRUCTURAL ❑ YENANT ❑ ELECTRICAL � PLVMBING ❑ MECHANICAL ❑ OTHER .VROJECT DESCRIPTION S�.F7. oCCUPArvCv CON STRUCTION TVPE VAWATION $ _ ZONE GRADINGCU.V�S. ACRES_ Remarks: � 'Z � j � � Preventer Irrigation Bathtubs Clarifiers rink�ng Fountains loor Drains loor Sinks as Service Outlets Kitchen Sink LavatOries P—Trap Roaf Drains Reinspection Fee � $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑4100,000 BTU 0100,000BT Reinspection Fee' � $15 CMF 0865-46, rev. 30/84 Wnite - BWltling; Canary - Applicanh Pink - Accounfin9; Goldenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection � Solar Collectors Salar Piping Solar Tank Swimming Pool w/Spa Urinal Wacer Closet � Water Heater Water Service � Auto-Wash + Laundry Trays Iwue Fae Hood or Typel ❑ Canopy Type I I ❑ :iefrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteration FireDampers � Registers Issue Fee FEES A.P. #'+ S Main Building: E T Front B Rear A C Right SLeft Ping. Ref. # � Planning Notes: Automatic Washer Construction PoleSub. CoOking Unit Dishwasher ' Dryers �Gas ❑Efec Fan F.A.U. Fixtures Device Boxes � Outlets Switches Garhage Disposal Generetor �0.5 KW C 1985 2/09/87 Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer � 15�50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Morors�0.1 HP �1'h-8 Inc.Solar �9�15 HP �16-15+ Microwave Pole Light Range Standing Sections 5-15 KW Trash Compactor $ 3 I � Reinspectian Fee $15 Ittue Fee FEES DEVEIOPMENT SERVICESRE�UIREMENTS: Zonine Approved By Building Appfoved By _ .. . . . _ n $ 3 SUMMARV� FEES BUILDING PERMIT $ SMIP $ PLAN CHECK � $ --�7—.�� PERMIT PLUMBING � $ ��y�� (�j�� ISSUANCE �$ PLAN CHECK 25°6 $_J v•�L ENERGY P.C. $ ELECTRICAL $ � GRADING $ PLAN CHECK 50% $ " MICROFILM $ MECHANICAL $ TOTALFEE � $ PLAN CHECK 25% $ CTION AND PLANNING ALS Permit # emporary Electrical Service or Pole 2. Soil Pipe-Undrgrnd. I3. Elec[rical Conduit Utility�Undrgrnd. ' 4. Electrical Conduit-Undrgrnd. , , 5. Steel Reinforcement 6. Electrical UFER Grnd. 7. Footings� � 8. Foundation� � 9. Water Pipe-Undrgrnd. - 10. Structural Floor System 11. Property Sewer Line & House Connection � 12. Sewer Cap 13. Roof Drains � 14. Fough Plumbing � 15. Rough Electrical-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19`'Rough Heating & Air Conditioning 20. Rough Factory Fireplace I 27: Ducts, in Structure 22. Ducts, Ventilating �. 23: Gas Pipe-Rough & Test � 24. Roof Framing 25. Roof Sheathing � 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding i 29. Insulation � 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. F1inal Gas Pipe-Test , 36. Hood.or Canopy 37�. Final Factory Ficeplace 38. Final Plumbing . � 1. - 39. Water Service-Final 40. Gas Service-Final � 41. Solar pomestic-Final � � �42. Backfldw Preventer 43. Backflow Irrigation '44. Landscape Irrigation System �45. Sound Attenuation 46�. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48.. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _ _ Date POOL & SPA Inspector qppROVALS Permit# 52. Pool & Equipment Location 53. Steel fieinforcement ' 54. Forms 55. Electrical Bonding ' 56. Rough Plumbing & Pressure Test 57. �APPROVALTOCOVER-GUNITE 58. Electrical Conduit�Undrgrnd. 59. Gas Pipe, � Undrgrnd., Test � 60. Backwash Lines, P-Trap, O Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final � 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final � 67. Fencing & Access Approval , � - 68. APPROVED FOR PLASTERING ' 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # _ � -I 'Y.. 0' Date � Inspector 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank � Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe �. .- 77. FIXED SYSTEM FINAL ' 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL,INSPECTION � . 80. FOOD CERTIFICATE ISSUED Notes: C e . � = ' f � �� 0 I V Applicant lo lill in all spaces except those within heavY borCe� Iines anE si9n all approD��ate tlecl ionz. CITY OF COSTA Ij2E�4� COp�N�STR CT O PERMIT PE IT � y.,�� ' TRACT NO. LOT NO. UNIT N0. Project Address �yE� w � � � � / , Applicant'S Mailing A�e55 TYPE OF CONSTRUCTION NEW /�DD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, �6 Owner's Name n � Phone DESCRIPTION OF WORK/USE OF BLDG. � Address �� (� � �—` S S Main Buildi Arch/Eng. License No. � TYPE OF PERMIT GRA�ING FOurvDATlo�v T ' ❑ STRUCTVRAL Ffont Addt255 � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAI A Rear ❑ OTHER Contracror's Name � � G Phone - �. - - C Right Address (mailing) � � PROJECT DESCRIPTION 5�. FT. OCCUPANCv K 3 CONSTRUCTIONTVPE VALUATION$ g Left Citylic2n5eNo. ZO GRADINGCU.VDS. ACRES LICENSED CONTRHCTOR DECL ATION Ping. Ref. # 1 hereby aftirm [hat t am licensetl ntle� provisions ot CM1artar 9(commoncing pemarks: ,� /� J/ � Plannin9 Notes: wi[h section 7000) of DiviSbh 3 of the Busine55 antl Profezsions Cotle, antl � my Ilcense is in tull a tl Ii � License Class � L' nse No � Date �Z7� Si9natUre \ WORKERS' COMP NSATION DECLARATION � \1 hereby aitirm that I nave a certificate o( consent to se t-insure or a certificate of workers' Compensation Insurance, or a certitietl cop�y,,/�thereof (Section ' 3800� Lab. C.L O�� iM/e/��.VL //U$C/QI�iIY/�G'' U; �olicy No. �� Company �, rtifietl copy Is hereby furnishetl. C ifietl�copy is filetl with the city Bui 'n9 ivision. Date APplicant E% MPTIO FRO ORKEqS' COMPE ATION CLARA ION (T�is section neetl n be com0letetl il Ihe permil i5 to ne huntlr¢tl (SI00) or lezs). 1 cerlily tha! in the� per/ormance of tho work for whicb this permtl Is Issuetl, 1 znall nol ¢m0�oy any Pe�son in any mann¢r So as to become subject t0 tM1e Work¢rs' Comp¢nsation Laws Df California. Date Si9pa[ure NOTICE: If,.af[er making this tleclaration, you snoultl become subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply witM1 SUCh p�ovision6 or this pe�mit Shall be tleemetl revokeC. CONSTRUCTION LENDING AGENCV 1 nereby a(tirm Ihat there iz a<onstructlon lentlin9 a9ency tor the pertormance of the work for which this permit iz ISsuetl (Section 3097 Civ. C.) tRntler's Name '� Lentler'S Atltl�ess , OWNER BUILDEH DECIARqTION ' I hereby affirm that I am exemp[ from the ConVa�tor's License Law for [he tollowin9 reason (Section ]031.5 Business antl Professional Cotle: Any city or �nuntv wnich reouires a oermit ro cnnsVuct. alter. imorove. tlemolish or�repair a si4netl slatement that he/she is licensetl pursuant to DiviSiOn 3 Ot V1¢ BIISIn¢55 drytl PlOI¢SSIOnS COdC) O! �[na[ ne/sna �5 axemp� [heretrom antl the basis for the allegetl exem0��on. AnY violation of SGction 7031.5 by any applicant for a permit subjectz the applicant to a civil �enalty of no[ more than five ryuntlretl tlollars (5500). ' J I, as owner oi the property or my employees with wages as their solo pmpensation, will tlo'the work, antl tho struccure is not intentletl or ofteretl .or sale (Section 7044, Business antl Pro�essional Cotle: The Contractor's License Law tloes not appry [ry an owner of a prOperry who builtl5 or Improve5 thereon, antl who tloes such �york himself/herself or through nis or her own employaes, provitletl that such improvements are not intentletl or offeretl tor Shce.' If, however, tbe builtling or Improvement is soltl within one yedr of com- pletion,'tM1c owner will M1ave the burtlen Of proving he/She tlitl not bulltl or im- prove f0/ the pu�po5e ot sale). - ❑ I, as owner ot the pro0er[y, am ozclusively contracting wi[h licansetl con- VactO/s lo <onsV uGt the O�o�e�t (SectiOn 7044, Business antl Pwte55ion5 Cotle: Tne Contractor4 License Law tloes not apply to an owner o( oroperty who builtls or improves thereon, 8ntl who conVacts lor such proiects wlth a con- t�actor(5I I�cense pursuani to (he ContraCtor'S Llcense Law). I am dware that proof ol their Worker's COTpensatlOn insu�ance Shoultl be ptovitle0 to me. � 1 am esempt untler Section B. & P. C. for IhiS red5on Daie �wner 1 hereby cer[ify that I have reatl this application antl state that the abova iniormailon �s correct. I ag�eB to comply with all city and county o�0inance5 antl state laws relating to bu��rJ ipg constructlon antl hereby authoriz¢ repre- sentatives of thi5 city to ef�[¢r upon the a�ove�-rQen[ionetl Pioperty fo� Signature ( � - Driverz' Ucense or 55 � Bar Sink ., Backflow Prevanter 8ackflow Irrigation Bathtubs Drinking Fountalns Floor Drains Floor Sinks GasService Outlets . Interceptors Kitchen Sink lavamries . P—Trep Roof Drains � � Reinspection Fee $15 Boiler . Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System. ❑ Multiple Firepl/FacL Blt. ICBO ��l � Heating System & Ducting 00.100,000 BTU �100,000 Reinspection Fae � $15 CMF 0865�4fi, rev. 30/8G White - g�idinq; Canary - APP��ant: Pink - Accoun[ing; Goltlenrotl - Assessor PLUMBING ' Showers' � Service Sink Sewer Cap � Sewer Connection Solar Collectors Solar Pipin9 ' Solar Tank Swimming Pool w/Spa Urinal WdlCf CIOSE[ . Water Heater _ Water Service Au[o�Wash laue Fee Hood or Typel '❑ Canopy Type I I ❑ Refrigeration System ❑aioo,000eru Oioo,000 System Repair/Alteration - Fire Dampers Registers . laue Fee FEES $ 3 $ 3 P.utomatic Washer Construction Pole Sub. � Cooking Unit ' Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. � Fixtures � ' Device Boxes Outlets Switches . Garbage Disposal Generator �0.5 KW 05-15 Fee I $15 .� � Req./Provided ELECTRICAL � Trensformer ❑ 15-50 KW ' ❑ 50+KW Meter ❑up to 100 amps' Meter �over 100 amps Sub Panel Motors 00�1 �HP O t Y. - 8 Inc.Solar 09-15 HP �16-75+ Microwave Pole Light ��y�� . - Standing Section5 Trash Compactor luue Fee DEVELOPMENT SERVICES REQUIREMENTS: �Zoning Approvad By Building Approved By AppliCation laued By � FEES $ 3 SUMMARV OF FEES BUILDINGPERMIT $ SMIP $ PLAN CHECK $ PERMIT - , PLUMBING $ ISSUANCE $ PLAN'CHECK 25% $ ENERGV P.C. .$ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ ' � MICROFILM $� MECHANICAL $ TOTAL FEE $ / � PLAN CHECK 25% $ � Z O N I N G R E � M T S CONSTRUCTION AND PLANNING � POOL & SPA APPROVALS Permit # Date Inspector qppROVALS 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-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement i 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE •. 7� Footings . 58. Electrical Conduit-Undrgrnd. • 8. Foundation � 59. Gas Pipe, O Undrgmd., Test _. 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. � 10. Structural Floor System 67. 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 � - 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T 8ar 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 OGas ❑Oil 23. Gas Pipe-Rough & Test � 72. Underground Flush � 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathin9 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. DrvWall 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 , � / � 39. Water Service-Final , 40. Gas Service-Final ' 41. �Solar pomestic-Finel � � ' , •42.-BackflowPreventer ' . _ , - � � 43: Backflow Irrigation � . ' �" . 44. Landscape Irrigation System . _ � 45. Sound Attenuation i , ' „ 46. Handicap Regulations i - 47. FINAL STRUCTURE & BUILDING „ � � - - , . 48. Special Requirements Completed . 49. Elearic Release to Edison •. , 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY � No. Date � ' � 1 Applicant to fill in all ipaces except lhose wlt�in heavy bo�Cer lines anO sign all apProprlate Ceclarations. CiTY OF COS7A MESn CON,.S+TRUCTION PERMIT Project Address —� �w � � '� �� T Applicant's Mailing Address Owner's Name. _.k�... Phone Addrecs Arch/Eng. License No. Address Contractor'sName—�� oB.2�.o� ��/ �ho�n[e��.+'��—_�/'� � Address (mailing) �� /` s ` ��-y�TT ` " '-"A City License No. �u7�� LICENSED CONTRACTOR DECLARATION I hereby dffirm [nat I am licansetl untler provislons ot Chart¢r 9(commencing with sectlon 7000) of Division 3 of the Business antl Protesslons Cotle, antl mY license is in f�ll /orce ntl ef/¢C[. �JCClISC C�d55 license No. Date ' 9 t _��C � WORKER ' CO PEN ATION CLARATION �ereDy aitirm that I have a cerliticate oi consent to selt-insure or a certiflcate WOrkers' Compensation Insurance, or a ccrtifietl wpy thereof (5� e800, Lab. C.) �I ��'''�` � � ' Policy No. ��{� Company _�(rj'� -��[_'e"ifietl�pPROMefORKE0.5aC0 BENSATDIONIDECLARATIO�� /E�XEMPTION (ThlsSection neeG not be cOmpleteE if the permit IS fOr One huntlratl (5300) or less). 1 certi�y that In the performance of the work for whlch this Oe�m�I Is ISsuetl, I shall mt employ any person in any manner zo as to become subject to the workers' Compensation L.aws of California. Date Signature NOTICE: If, after making this tleclaration, you shoultl become subject to the ' Worker5' Compensation prOvizlons ot the LabOr Cotle, you must forlhwith I comply wilb su[h provisions or this p¢rml[ snall be tleem¢tl revokeE. CONSTRVCTION LENDING AGENCV 1 hereby aillrm that there is a cons(ruttion lentling a9ency for the performance o( the work for wnich thi5 permit is Issuetl (Section 3097 Civ. CJ Lentler's Name �Len0eY5 AEtlress OWNER BUILDER DECLA0.ATION • I hereby affirT that I am ozempt trom Ihe Contractor's LlcenSe Law tor the tollowing reason (Section 7031.5 Business antl Professional Cotle: Any city or county which �equires a pe�mit [o const�uG[, alter, improve, tlemolish o� repair any structure, pdor to its iszuance, also requlrez the applicant (or such permit to file a 5i9ne0 statem¢nt that he/She is li[enietl pu�suant t0 the p�oviSiOns of the Contractor'S License Law (CnaO�er 9(commenUn9 witn Section 7000) ot OlviSion 3 ot [he Bu5ine55 and P�ofes5ions Cotle) or tha[ he/she IS exempt :herefrom antl ihe basis for tne alle9etl ezemption. Any violation of Section 7031.5 by any applitant fOr a permit subj¢C[5 tbe appli<an[ to a civll �e�dlty of not more Ihan tive huntl�ed tlo11a�5 (S500j. U I, as owner ot tne property or my employees with wages as their sole compensatlon, will tlo the work, antl the structure is not intentletl or offeretl tor sale (Section �044, Buslness antl Protessional Cotle: The Contractor's LicenSe Ldw tloes not appty to an owner of a properry who builds or improves tpereon, antl who tloes such work himseli/hersaH or throu9h nis or ho� own employ eez, providetl that such improvements are not intentletl or otferetl for sale. It, howev¢r, tne builtlinq or improvement iz so1C within one year Of com- pletiOn, the Owner will have tha buttlen Of Proving he/She tlid nol buI10 or iT- prova forthe purpose oisale). ❑ 1, as owner of tM1e proporiy, am excluzively cantractin9 with Ilcensetl con- [ractoR t0 mnstruct the project (Section 7044, Business antl Profes5ions Cotle: The Contractor's License Law tloes noc apply to an owner ot proparty who builtls or imoroves thereon, antl who contracts for sucn projects with a con- tractor(5 Imense pursuant to the Contracior'S License Law). I am awa�e:that proof o� their Worker's Compensation insurance shoWtl� be provitlatl to me. ❑ I am exempt untler Section B. & P. C. for thls reason �oate Owner I hereby cerNfy that I have reatl intormation is mrreci. I agrce to < antl state laws lating to builtlinc sentatives ot his city to enter, kiverS�Licanse or 55 � � � 0865-46, rev. 30/84 Wnite - Bulltling; Canary aDove TYPE OFCONSTRUCTION IJ NEW�ADD LJ ALTERATION LJ REPAIR ❑ GONVERSION ❑ DEMOLISH OTHER p� p�k DESCRIPTION OF WORK/USE OF BLDG. � S Main Buildi � E TVPE-OFPERMIT GRADING FOUNDATIO[[['''��N STRUCTVRAL T FrOnt '� TENANT ❑ ELECTRICAL ❑ PWMBING }� MECHANICAL B Rear �O'OTHER ! \ A PROJECT DESCRIPTION 5�. F7. oCCUPANCv C Right K Left ' CONSTRUCTION TY,PE VALUATION $ $ ZONE GRADING CU. VDS. ACRES p�ng. Ref. �r` Remarks: ,�� Planning Notes: ` . f�. .. �-. � � . Backflow Preventer Backflow Irrigation Drinking,Fountains Floor Drains � Floor Sinks Gas Service Outlets . $ink Roof Drains Reinspection Fee � $15 Duct - Under Ground Duct - Strucmral Duct - Ventilating Exhaust System 0 Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting I�P700,000 BTU 0100,OOOBT .� Reinspection Fee $15 Plnk - Accounting; Goldenrotl - Azsessor Showers Service Sink $eWer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Water Closet Water Heater Water Service Auto-Wash Laundry Trays Issue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System 00-100,000 BTU ❑ 100,000 BT System Repair/Alteretion Fire Dampers Registers � Issue Fee FEES �3787 3/11/87 I� Zone Accessory Building: ELECTRICAL Automatic Washer Transformer ❑ 15-50 KW ConStructionPoleSub. ❑ SO+KW Caoking Unit Dishwasher Dryers ❑Gas ❑Elecvic Fan F.A.U. � Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0.5 KW �5 15 KW Meter LJup to 100 amps Meter ❑over 100amps Sub Panel Motors OO-1 HP 01'/a - 8 Inc.Solar �9-15 HP �16�15+ Microwave Pole Light Range Sign Standing Sections Tresh Compactor $ 3 Reinspection Fee $15 Issue Fee FEES � DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By — �� $ 3 BUILDING PEFMIT $ PLAN CHECK $ PLUMBING, $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ 45 5 Z O N 1 N G F E Q M T S FEES $ 3 RV OF FEES _ SMIP - $ — PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ � TOTALFEE $ �� / 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 3. Electrical 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. APPROVALTO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 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 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 J y � FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # _ 21. Ducts, in Struc[ure 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.Sto.rageTank OGas ❑Oil 25. Roof Sheathing �, 74. Overhead Hydro + 26. T-Bar Ceiling (Structural) & Monocoat :� 75. Dry Chemical ' 27. Frame and Flashing , .� � 76. Dry, $tandpipe � 28. Lathing & Siding ;� . �77. 'F.IXED�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: j_9.� ' 34. Final_Heating & Air Conditioning . O .. 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 pomestic-Final � , � 42. Backflow Preventer , ' " " 43. Backflow Irrigation ; ' � - r 44. Landscape Irrigation System � „ . , 45. Sound Attenuation . . 46. Handicap Regulations � � • . � 47. FINALSTRUCTURE&BUILDING , " � . • � 48. Special Requirements Completed � � � 49. Electric Release to Edison � �50. Gas Release to Southern Califomia Gas Co � 51. CERTIFICATE OF OCCUPANCY , Date AOP��canl to fill in all s0ace5 exeept ihosa wilhin �6F COSFa ME C Sr,T�RUCTION^ PERMIT 'ProjectAddress � z �'/d �N� ' Appiicant's Mailing qddress Owner's Name �� C�� Phone Address .. ' ' Arch>Eng. License No. , Address Contractor'sName � Phon� �'� � Addresslmailingl/T��NN�l7DR�i� � '��fi �'�/RJ�iGaG� City License No� �('i�� — t��!��1� LICENSED CONTRq�TOR DECLARATION 1 M1ereby attirm IM1at 1 am licensetl unticr provisions ot Chartcr 9(commentlng with section ]000) Of Division 3 of tbe Businezs antl Professlons Cotle, antl my Ilcense is in full tprce antl effect. � e License Class �' � �0 l.icense No. �'9 � S S TJ Da[e '�S � Si9nature WORKERS'�SATION DECLAfiA' ION 1 nereby atfirm that I bave a certificate oi consent to selbinsure or a certiticate ot workers' Compensation Insurance, or a'certitietl copy thereo( (Section 3800, Lab. C.) Policy No. Company _ 8 Certitietl capy is qereby furnishetl. Certifietl copy is f�letl with'the city Builaing Division. Date ' Applicant EXEMPTION FROM WpRKERS' COMPENSATION DECLARATION (Thissection neetl no[ b¢ completetl if the permit i5 for One hund�etl ($300) o� less) I c¢/tify that in tM1e berfo�mance of the wo�k for Which this pe�m�t is issuetl, I Shall no[ em0loy any pe�son in any manner so a5 to becom¢ sup lect to the Workers' Compen tlon Laws of California. / nf� Date' '. .�_:-5i9nature ��%�� ;% '�—� � NOTlCE: If, atter maia{ng this tleclaration, you shoy tl become subject to the Wovkers' Compensatjbn pvovision5 of the Labor Cotle, you must torthwith mmply witM1 such O�ovision5 or this permit shall be tleemetl �evoketl. CONSTRUCTION 4ENDING AGENCV • � 1 hereby affirm that there is a mnstruction lentlin9 a9ency for the performance of the work fo� Which this pe�mit is Issuetl (Section 309] Civ. C.) Lentler's Name �Lentler'S,Atltlress OWNER BUILOEN GECLARATION 1 hereby affirm that I am ezempt from the Contracto�'s Llc¢nse Law to� lh¢ following reason (Section �031.5 Business antl Professional Code: Any city or county which requir¢s a permit to construct, alteY, improve, demolish or repair any structure, prb� to its is5uance, al5o requi�es the appliCant fo� Such pe�mit to fiie a signetl statemen[ that he/she is licensetl pursuant to the provisions of the Contractor'S Lic�nse Law (Chapter 9,(commencinq with Section �000) of �ivlsion 3 of the 9u5ine55 antl ProfesSiOns Cotle) or that h¢/she is exempt therefrom antl the h�5is for the allegetl exemptiOn. Any viOlation of Sectiop 7W3.5 by any applicant for a permit subjects the applicant to a civil �enalty of not more than five nuntlretl tlollarz ($500). LJ I, as owner of [he oroperty or my employees witn wages as their sola compensation, will tl0 Ihe work, antl the st�ucture is not intentletl o� oHeretl tor sale (Section 7044, Business antl Professional Cotle: The Contractor's LicenSe Ldw tloes nOt appty to an owner ot a property who builtls or imp�ove5 thereon, antl who does such work hlmseH/herself or through his o� her ow❑ ¢mployees, p�ovitled that such improv¢ments a�e not Intentletl or offe�e0 for sal¢. If, however, the builtling or imp/ovement is SOIG within one yea� of [om- pletion, the owner WIII have the bu�tlen Of provipg he/She tlitl not builtl o� Im- prove tor the purpose of sale). ❑ I, as owner of the property, am exclusively confracting with licensetl con- lractors to consV uCt Ihe pro�ect (Section 7044, Business antl Professions Cotle: The ConVactor's Li�ense Law tloes not apply to an owner ot property who builtls or improves [hereon, antl who mnt�acts tor such projects with a con- tracior(s) i¢ense pursuant to the Contractor's License Law). I am aware that proof of tneir Worker•s Compensation insurance shoultl be provicletl to me. ❑ I am exempt untler Section B. & P. C. for this reason Date I hereby certity tnat I information is corre�t. antl state laws relatinq sentatives of thi5 City inspection purposes Si9nature �^r, Drivers' License or $5 � CMF OB65-46, rev. 30/84 _ Owner have reatl tnls applicatipn antl state that the above agtee to comply with all city antl <ounty o�tlinance5 o builtling construction, antl hereby authorize repre- to entet upon, the above-mentioneA O�operty for bortler lines antl sign all aOP�oPriate tleclarations. . ",..... ....._. __. LOT NO. UNIT NO. �_ �� , ��"� 7 S,(3 TYPE OF CONSTRUC710N NEW ADD ❑ CONVEFSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. — ALTERATION LI REPAIR TVPE OF PERMIT LJ GRADING LJ FOVNDATION U STRUCTURAL ❑ TENANT �,ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SO. FT. oCCUaArvCV_ CONSTRUCTION 7VPE VALUATION $ ZONE GRADINGCV.VDS. ACRES_ Rem�aki: Bar Sink Backflow Preventer Backflow Irrigation eathtubs Clarifiers Dishovasher '- Drinking Fountains Floor Drains Gas Service Outlets Incerceptors Kitchen Sink .. Lavatories P—Tiap l • Roof.Drains ' Reinspection Fee $15 Boiler Duct- UnderGround Ducc-Structural - Duct- Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIt. ICBO # Heating System & Ducting ❑0.700.000 BTU �100.00OBT peinspectian Fae White - Bulltling: Canary - qpplicant; Pink - Accountinq; Goldenrotl - Assessor $15 PLUMBING Showers Service Sink Sewer Cap Sewer Connection � Solar Collectors Solar Pipin9 � Solar Tank Swimming Pool w/Spa Urinal Water Closet - � Water Heater Water Service Auto-Wash Issue Fee Hood or ' Type I .❑ Canopy Typell ❑ Refrigeretian System ❑0.100,OOOBTU ❑700,000 System Repair/Alteration Fire Dampers fiegisters � . laue Fee FEES A.P. # S Main ildi E T Front 8 Rear A C Right K Left S Ping. Ref. # Planning No[es: Automatic Washer Construction PoleSub. Cooking Unit Dishwasher , Dryers .BGas ❑Elec Fan F.A.U. = 3104 3/D2/87 Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Device Boxes ` 7 Outlets 7 - �' Switches '1' Garbage Disposal , '1 Generator �765 KW �5-15 KW $ 3 $ 3 � Meter dup to 100 amps / . Meter over 100 amps Z Sub Panel Momrs OO-1 HP �1 % - 8 Inc.Solar �9-75 HP �i6-15+ Microwave Pole Light Range Si9n Standing Sections Trash Compactor � Reinspection Fee ' $15 luue Fee � DEVELOPMENTSERVICESREQUIREMENTS: . � Zoning Approved By •Building Approved By � Application laued By � SUMMARV OF FEES BUILDING PERMI7 $ SMIP $ PLAN CIiECK $ PERMIT PLUMBING $ �SSUANCE $ PLAN CHECK 25% $� ENERGV P.C. $ � - ELECTRICAL S - GRADING $ PLAN CHECK 50% $ 3 . � MICROFILM $, MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ 105.45 TL FEES $ 3 Z O N I N G R E Q M T S ,CONSTRUCTION AND PLANNING APPROVALS Permit# 1.� Temporary Electrical Service or Pole 2. SDiI Pipe-Undrgrnd. 3. Electrical Conduit Utility-Undrgrnd. 4. -Electrical Conduit-Undrgrnd. � , 5. Steel Reinforcement 6. €lectrical UFER Grnii. 7. Footings ' . 8. Foundation - 9. Water:Pipe-Undrgrnd. 10. Structural Floor System 11. Property Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing - 15. Rough Electrical-Conduit 16. Rough Electric Wiring� ��S�wGy , 17. Rough Wiring Sign T�A^ �� 5 c 18. Rough Elect�ical-T Bar Ceiling 79. Rough Heating & Air Conditioning 20. Rough Factory Fireplace � 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frameand Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 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 �47. Solar� Domestic-Final �42. Backflow Preventer � 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handica'p Regulations � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY Date Date L�DI� , " � PO� � SPA ,Inspector � pppROVALS Permit #- v ' .. 52. Pool & Equipment Location� 53:.4$teel Reinforcement L/ G E 54. Forms 55: Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, 0 Undrg�nd., Test � 60. Backwash Lines, P�Trap, 0 Undrgrnd. 61. APPROVAL TO DECK � 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electcical-Final 66. Solar System-Final 67. Fencing & Access Approval � ;68. APPROVED FOR PLASTERING 69. POOL/SPA SYSTEMS FINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro ,71. ProductPipingOGas ❑Oil 72. Undeeground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro ' 75. Dry.Chemical � 76: Dry Standpipe � ' 77:' FIXED SYSTEM FINAL 78. FIRE PREV. FINAL . HEALTH DEPT. REQUIREMENT 79. FINAL�INSPECTION � 80. FOOD CERTIFICATE ISSUED Notes: a 0 Date � Inspector �