HomeMy WebLinkAbout185 19TH ST - Building Permits PROJECT AOORE55: 185 E 19TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06801';
OWNER'S NAME: SCUDDER MARY LOUISE
ADDRESS: 185 E 19TH ST PERMIT NO: P 068017 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA, CA 92627
CONSTRUCTION TYPE: PERMIT TYPE : PLU PURPOSE: ALT
714 642-2038
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REMOVE WATER HEATER WASHER & DRYER SQ FT:
ADDRESS: UNIT:
CLAIM VALUE; CALL—VALUE: GROUP OCC ; R-3 /
PERMITTEE: PIPE SURGEON INCORPORATED ( 714 ) 832-1888
ADDRESS: P.O, BX 11355 COMMENTS : ONLU PLUMBING WORK
COSTA MESA CA 92627 ********************-**********-*t***-*-**********4***********atat*r***,.*4t#3E16**********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that l am licensed under provisions of Chapter 9(commencing with Section Z ON I NG REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect.
CITY LIC.: 028621 STATE LIC.: 433.34,(. ��C�j�U�lAAA'�$S: C '6 EXP; 04 /95 SE TBACK S
2. -94 Signature:fp�W-�"� — MAIN BUILDING ACCESSORY BUILDING
�eT — 'n FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
WORKERS'COMPENSATION DECLARATION: 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 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: NWC248046 EXP.DATE: 11 /01 /94
COMPANY: GOLDEN EAGLE PARKING REQ; PROV; PARCEL : 42523412 ZNE: REF NO:
m Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES>
t >
_ 3 —12� !7 Applicant: t `_ - - *iE*****************iE*3E**3!****!E#**it*i ********iF**********iE*****************iF*****
z
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be competed if the Pernut is for one hundred(5100)or less). DEVELOPMENT SERVICES . REQUIREMENTS
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject t0 the workers'Compensation Laws of California. ZONING APPROVED B Y • • •—
•
DATE;
Date: Signature:
NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APP ROVED BY ; _- DATE: _
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. )_ q L
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: Irk 4J _ `f
which this permit is issued(Section 3097.Civ.C). **********************'**** ;T n.. It tic ** It wit It ' * -n-/t" DATE;
**********4t*xx****n.Le**
LENDER: *************************************?F****a.*****%******************************
ADDRESS: LEGALIZATION:Y F E E SUMMARY STRUCTURAL SEGMENT :N
OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 38 . 00
repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 , 00
I. as owner of the property or my employees with wages as their sole compensation, will do the work. and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 38 , 00 20 , 00 0 , 00 58 .00 58 , 00 , 00
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.If, however the building or —_
improvement one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUEDIVISION
OD58 . 00
OVER/SHORT;
4 lorthepurpose of sae) BLDGPMTPLUMBING ELECTRICMECHANICFIRESMIP/TOT
GRADING PLAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 58 , 00
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and whocontracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). l am aware *************************************************************j,.*****************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL ' F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
tor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date. owner: PLU 1 LAUNDRY TUB OR WASHER
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and PLU 1 WATER HEATER AND/OR VENT 7 , 00 7 . 00 7 , 0 0
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a FLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 , 00 7 , 00
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from 5 . 00
these provisions. END OF FEES
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county J.
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property Ioi inspection purpo�ses. .. 01 00263876-00163876 TOT 58.00
�.—rAlr / X.--I lAN/La(� �� _Signature: ` /3' KNW'-- DATE: 07/12/94 TIME: 13:12
Drivers License or Social Security a:
1641.46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
1\ •
CONSTRUCTION AND PLANNING POOL A
' APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service& 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. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
•
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10, Structural Floor System 61. APPROVAL TO DECK
J
11:Property Sewer Line & Houie'Connection rr 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 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73, Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro 4
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 PREY. FINAL
30. Drywall Nailing i 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 / ' !)r`-3C_ .c, CP-41444R- b �_
35. Final Gas Pipe-Test 6 1.
36. Hood or Canopy - . •l
37. Final Factory Fireplace
38. Final Plumbing (7 13.€�. I
39. Water Service-Final �(
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer -
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
•
No. Date
P'AC/ACTAD9RESS: 185 E 19TH ST UNIT: _ CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05008:
'OWNER'S NAME: SCUDDER MARY LOUISE • •
ADDRESS: 185 E 19TH ST PERMIT NO: B 050083 PLAN CHECK NO: N GOVT: N SUN): N
COSTA MESA, CA 92627 •
CONSTRUCTION TYPE: PERMIT TYPE: SIR ' PURPOSE: ALT
ARCH/ENGINEER: '. 14 642-2038REG.NO.: JOB DESCRIPTION : REROOF BACK OF HOUSE W/COMP O/1 COMP SQ FT: 351
ADDRESS: UNIT:
PERMITTEE: �� CLAIM VALUE : 851 . 00 CA.LC—VALUE: , 851 , 00 GROUP OCC: R-'3 /
CRANK BROTHERS ROOFING ( 714 ) 548-5569 r
ADDRESS: 126 COMMERCIAL WAY COMMENTS; ItFiikC)OF I LAYER COMP 0/1 LAYER COMP •
C .M. CA 92627 *********r;.%;.X X****** *NX7*%*%****x-*x EH***********************N-�:� *** .*******x'*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(comm g with Section ZONING R E U I- R EMENTS
7000)of Division 3 of the Business and Professions Code. an, my license is in full force and effect. • — S E .r BQA C K Jn
CITY 900 gq•a ,4TE uc.:408re: CLASS: C'/� ---------
WORKERS'
e) signature:— _ _ — M11'N BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby af' 'at ave a certificate of consentto self-insure or a certificate of Workers' F1tNT: FT LN REAR : FT IN FRNI: FT IN REAR : FT IN
Compensation Insurance.or a certified copy thereof -ctio 800.Lab.C). LEFT: CT IN RCHT: FT IN LEFT: FT IN RGHT: FT IN •
POLICY NO.: 23522490 XP.DATE: 01 /01 /91
, COMPANY: STATE PARKING R3/1'�: PROV: PARCEL: 42523412 'LME: REF NO:
❑ Certified copy is hereby furnished. 54 Certified copyr with they Built° Division. ' PLANNING NOTES> •
/ /�/� / C
—
Date. de fo APPlican s� _ �/ J ✓ /�31� ?E**1k******Y. %%:•:kx.xY:,3f1E+****%**iE*******************+F**1tiE*!E}:****of*iF %*i(df**#ab'%+r?O**** '
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). , DEVELO PMENT SERVICES R: E . Q U I R E M E N -T S
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become '
subject to the Workers'Compensation Laws of California. ZONING APPROVED 3Y ,
DATE:
Date: Signature: -
NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROV( 0 HY , DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED i:i V : DA•1'E: 11-7-111q0
which this permit is issued(Section 3097.Civ.C). %*********%%?:% %%'Ef** 1(-****!E?Eiw±E,r+F? ?t Y.-. * WIc*****#**1f****************3 * ****. **i *
LENDER: _ %******JE***** fi%M*****************. ** **+F****** ******* ?E***********?E*******
ADDRESS: LEGALLZATION :N F E E SUMMARY STRUCTURAL SEGMENT:Y •
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT2 3 . 0 0. . 50
repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—R ES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN -
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEF
n
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and tee •BUILDING—DIV--. PERMIT ISSUE PLAN -C HECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS—--—> 23 , 50 0 , 00 0. 00 23 . 50 2 3 . 5 0 . 00
. L - 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 employees.provided that such improvements are not intended or offered for sale.If,however the building or
• improvement is sold within one year of completion,Me owner wilt have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 2.3. 5 0 OVER/SHORT: . 00
mrthe purposeof sale). - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN--CHECK
I.as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 23 . 00 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon • '
and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law), l am aware *->(.*g.yXY.k7i-%****'r.#*:x''t******?:'f********?f***:4********+!*)ETF********,.***i!*****?F 16*+?f d¢****
That proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. s P.C. .i, N 0 I V' I D U A L F E E BREAKDOWN
for reason: TYPE DESCRIPTIOQTY . I O N UNIT COST TOTAL COST
Dale: Owner: .
I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505.25533.and SFR 851 it IEI2UOF B Y, VALUE: R E:S IJ)I:N'i AL NOZONE 1 . 00 $51. , 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. •
Date: Applicant: _ ,
•
I hereby certify that I have read this application and slate I .: the above information is cor .gree to comp with all city and county
ordinances and state laws relating to building construction afi ereby authorize represen._..e>1 is city to ent' .pon the above-mentioned •
property for inspection purposes__
��/��� / �j C •'z 0100075095-0007509E Toldt 23.50
Date:�Z_/'4 �� Signa - `-1 // DATE: 11/23/90 TIME: 11:45
<—
Driver's License or Social Security x:
•
C-
1641.46 White—Building:Green—CodEnf/orcemenC Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
I
CONSTRUCTION AND PLANNING POOL & SPA
-..:111 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. ' I 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. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation ._ f', 59. Gas Pipe,0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. ,, 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
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 1 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
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 .+ '
I-, + 78. FIRE PREV. FINAL '
30. Drywall Nailing I' _ HEALTH DEPT.+REQUIREMENT
31. Plaster Brown Coat : t '" : ,79. FINAL INSPECTION ; '
32. Electrical Power Meter-Final - 1 `.11: , .80. FOOD CERTIFICATE ISSUED
33. Final Electric
i' Notes:
34. Final Heating& Air Conditioning .;,,I ,,
\.` f
35. Final Gas Pipe-Test - i •'. n - . r,
36. Hood or Canopy , ,
.
37. Final Factory Fireplace • : ' ,
38. Final.Plumbing i .
39. Water Service-Final ' i it + '
40. Gas Service-Final ' - ' ' - , .
41. Solar Domestic-Final '" i l i '
42. Backflow Preventer, ` I j I I; ; - . ,
43. Backflow Irrigation ; + • ' - '
44. Landscape Irrigation System .. . - ; i
45. Sound Attenuation•
46. Handicap Regulations ' - - :
47. FINAL STRUCTURE & BUILDING f >_/ tjoI o$ - '
1. 48. FINAL PLANNING • i I;w I' ' . '
49. Electric Release to Edison I
.
50. Gas Release to Southern California Gas Co ( 'JI'
51. CERTIFICATE OF OCCUPANCY i . .
No.' Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 4919 fi/14/95-
. 7Bp67 TL
OSTA M SA CONSTRUCTION FI;RMIT, P MIT TRACT NO. LOT NO. UNIT NO. -
. Project Address 'VS' 6 ' s- v • / V 9Z s�
Applicants Mailing Address P/t - ' TYPE OF CONSTRUCTION NEW U ADD U ALTERATION U REPAIR" - - -' „�
L ❑ CONVERSION ❑ D OLISH ❑ OTHER y
• Mir
// ^� //1 7 A.P.# 42.5
/ // Zone �`
Owner's Name /P,�2lt LI /t CL%CIC E•r`•phoner/ ren s� 42.5 —Z34-/2
DESCRIPTION OF WORK/USE OF RL
Address A"AJP� - �J,� S Main Building: • ' Accessory Building j� doe* Z
Arch/Eng. ' License No.. • TYPE OF PERMIT ❑ GRADING FOUNDATION Utt"STRUCTU RAL T Front - - �// '' •.'' . O
Address ' _ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL . • B Rear .
- �� -{� - N
Contractor's Name' 0WNEaQ� . . Phone C Rght {�. N
•
❑ OTHER . 1 A •
'3 �-b TDa La . • I
Address(mailing) ' • = . PROJECT DESCRIPTION 50..F1�T'_����; OCCUPAN Y 'M e K / L P. L - G
City License N_o. • , 'CONSTRUCTION TYPE ' s' VALUATION$ 7eQ2 S Left, • 5 —I� . •�'1 / ' •, R
LICENSED CONTRACTOR DECLARATION - ZONE GRADING CU.YDS. ACRES 'Ping. Ref.# Parkkiin_g RReq./Provided '' - E
thereby affirm that I am licensed under provisio f barter 9 (commending Remarks: _ •
Planning-Notes: 4tfi�, �/ � pW3Q7ca �4 e. M
with section 7000) of Division 3 of the Busine s a d P fessions Code, and '^^r T / f - • `lam -f
my license is in full force and effect. I , i - -
License Class License ;
S
Date ' • - Signatuie ' : PLUMBING . FEES ' 1'
•
WORKERS'COMPENSATION DECLARATION Bar Sink ' Showers - • ELECTRICAL I FEES
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 Backflow Preventer Service Sink Automatic•Waiher - Transformer ❑-15.50.KW
3800, Lab. C.) .- _ _
Policy No. ' ' Company - Backflow Irrigation $ewer Ca0 50;KW —
Certified copy is hereby furnished. p Construction Pole Sub.
Certified copy is filed with the city Building Division. • Bathtubs , Sewer Connection Cooking Unit • Meter Cup to 100 amps
Date Applicant - - • - - .
EXEMPTIONFROM WORKERS'COMPENSATION DECLARATION Clarif ief5 , Solar Collectors Dishwasher Meter Dover 100 amps-'
(This section need not be completed if the-permit Is for one hundred ($100) or _ - _ . - _ _
lets). Dishwasher , Piping Dryers ❑Gas' DElectric Sub Panel -
Solar Pi in ,
I certify that in the performance of the work for whi h is permit is Issued, I - _ • -
shall,not employ any person in any/ armor so z o ecome s bj9Ct to te Drinking Fountains i Solar Tank ' ' Fan. .Motors 00-1 HP ❑1'/a-8 I
Workers' o s J_-���j Laws of C lif A. Y dJ.� f . ❑
.,Date Signature LalQL,CE_ p F.A;U. Inc.Solar' 9.15 HP 0-16-15+'Kj Floor Drains SwimmingPool w/Spa
NOTICE:If,afte making this declaration, yo0 should become subject to the . - - ;
Workers' Compensation provisions of'the Labor Code, you must forthwith Floor Sinks Fixtures •
Urinal I rMicrowave
comply with such-provisions or this permit shall-be,tleemeB revoked. - '4 - ' - -- , - - - 1
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light
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 Outlets Range ' '
Lender's Name' • ;Dr's _ _
Lender's Address AlA /�•G - • Kitchen Sink Water Service I _ Switches Sign
OWNER BUILDER DECLARATION -
• I hereby affirm that I am-exempt from the Contractor's,License Law for the • Lavatories , s.- . • - Garbage Disposal i 1 Standing Sections • '
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 Generator ❑0-5 KW ❑5-15 KW Trash Compactor
any'structure, prior to its issuance, also requires the applicant for such permit P
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 _-
.;,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 _
4$ ' enalty of not more than five hundred dollars($500).
Wr•I •• Ir I; as owner of the propertyI'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 _ - Reinspection Fee :I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES
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 DEVELOPMENT SER I ES EC1UI TS:
efnpioyees, provided that such improvements are not Intended or offered for Boiler I Hood or Type I 0 1/(1(C/ /q / L�y,./,1,��
sale. II. however, the building or Improvement is sold within one year of com- , Canopy Type II 0 Zoning Approved By y/v�j �Q� �s Data (�� / 1
Prove f, rhe owner will have the burden of proving he/she did not build or im- Duct- Under Ground BuildingApproved B C/tel _Date /%�/pJ
Prove for the purpose of sale). - pF y Y r Q
❑ I, as'owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System . ' , Application Issued By Date
tractors to construct the project (Section 7044,Business and Professions Code: - .
The Contractor's License Law does not apply to an owner of property who I Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who'contracts for such projects with a con- O e�0
tractor(s) license pursuant to the Contractor's License Law). I am aware that �� BUILDING PERMIT $
ref, SMTP $ V
Proof of their Worker's Compensat'•n insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK $ i 51. /7 PERMIT
0 lam exempt under Section i Pr ti 8 P.C.f r is reason Firepl/Fact.BIt. ICBO# Fire Dampers PLUMBING $ ISSUANCE $
)( ^ ars L •
Date - owner t f, Heating System&Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certi-SShave re d t is apps ',Lion and state that the above ❑0.100,000 BTU ❑100,000BTL ' • GRADING $ •
in formatio s orrect. agree t c - ELECTRICAL $
n 9 ply with all city ande y county rite repre- PLAN CHECK X50% $ • MICROFILM $ •
•
sentaand-state laws rel M9 to nil in9 onstr uctlon and hereby authorize repro- _
inspecivetlo
ro( city to r' 'on In a ve-mentionetl property for , MECHANICAL $ - TOTAL FEE $ /8' 67
g 1\ J (�//�•.i •
X Signature aL•LL _
/ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF'0865:46,rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor " ' - - - '"' - '
CONSTRUCTION AND PLANNING POOL a 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 - :to -
;(:'Electrical Conduit-Undrgind. - 55. Electrical Bonding
B..Steel'Reinforcernent 56. Rough Plumbing& Pressure Test
6.:Electrical UFER;Grnd. 57. APPROVAL TO COVER-GUNITE
-7:'Footings 58. Electrical Conduit-Undrgrnd. t ;
8- Foundation • =1 59. Gas Pipe, O Undrgrnd.,Test
9. Wit& Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. ,I
10,, -StruciuraI Floor System 1 61. APPROVAL TO.DECK _
11:Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer'Cap • 63. Heater& Vent-Final - •
13. Roof iDrains 64. Plumbing System - Final • i
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 , i 71. Product Piping 0 Gas. 0 Oil
?3.'Gas Pipe-Rough p;Test' , 72. Underground Flush
24. Roof Graining I •• 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof-Sli'eathing - - 74. Overhead Hydro
•
26. T-Bai-Cejling (Structural) & Monocoat - • 75. Dry Chemical - '
Z7. Frame a`nd Flashing 76. Dry Standpipe
X18. Lathing&Siding 77. FIXED SYSTEM FINAL
129. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat r 79. FINAL INSPECTION I .
32. Electrical Power Meter- Final 80. FOOD CERTIFICATE ISSUED If
33. Final Electric Notes:
34. Final Heating&Air Conditioning {
35. Final Gas Pipe-Test
•
36. Hood or Canopy '
37. Final Factory Fireplace -
38. Fine, Plumbing .,
39. Water Seivice-Final -1
A--'
40. Gas Service-Final .I.4)
-
41. Solar Domesti&Final `.
-
42. Backflow Preventer
-
43. Backflow,lrrigation - '' -
-.,�.
. 1'
44. ,LandscagerlYrigatian Systeq"t - • -
45. Sound Attenuation-i •--
46. Handicap,Regelations "i
47. FINAI<;STRUCTURE & BbILDING 6f�71kCC/C_
48. Specialgtequi'ertlenis Com feted /
49. Ele&c riwRelease to Edison - - - - _ - i, - t,
.-'
50. Gas-Reiease to Southern California Gas Co r . - -
51. CERT4FICATE-OF OCCUPANCY _ . _ - _- - .
No Date -