HomeMy WebLinkAbout221 19TH ST - Building Permits • PROJECT ADDRESS: 221 E 19TH ST UNIT: ' + CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 046142
I( awxEflsRAME: SANDY WADDELL - . -
Aw"E�' 1430 SANTANELLA TERRACE PERMIT ,NO: E 046142 PLAN CHECK NO• : N GOVT : N SUPP : V
CORONA DEL MAR
• CA 92660 CONSTRUCTION TYPE: 5-N PERMIT • TYP.E: ELE PURPOSE: OTH
' ' 213-'251-6481 '
ARCH/ENGINEER: RICHARD NA'CLANI) - REG.xo.:C =6597, •
JOB DESCRIPTION : ADD ' $EC' ROOM ABOVE EXIST. GARAGE. • SQ fT: . '
ADDRESS: : 2418 MACARTHUR BI, UNIT: 6500 •
- NEWPORT BEACH CA 92660 CLAIM VALUE: - CALC-VALUE: •
GROUP .00C: R-3 /
PERMmEE: SANDY WADDELL ( 213 ) 251-6481 - • •
ADDRER& 1430 SANTANELLA TERRACE COMMENTS: -REF 18E45369
CORONA DEL MAR • CA 92660 ***********>E*+E+tie**)E*et*ea* Let**;rpt*****+tee*aE**u-+E*it*****x*****x-*x****+e>Fie)<t***xiedt****x '
UCENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R £ Q U I R EMEN 1' S '
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. - . , S' E T, B A C K S ' '
Cm UC.: ' u STATE LW.: CUSS: ' - •
I
Date: Signature: ---- ------ - MAIN BUILDING --- -- - ACCESSORYBUILDING ---- -
•WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' 6RN1': CT IN REAR: FT IN FRNT: FT IN REAR; FT IN '
Compensation Insurance,or a certified copy thereof`Section 3800,Lab.C). LEFT: FT , IN RGHT : . FT IN LEFT: FT IN RGHT: FT . IN '
POUCY No.: ' EXP.DATE: - . ,
COMPANY: PARKING REQ: PROV• : PARCEL : • 42540418 ZNE: REF NO:.
•
' Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> . .
Date: ' Applicant: *************iE*****************!t**iI***********ittEyt**3e************it*it**********3E*
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is or one hundred($100)or less). , D E 'V E L O P M EN T• SE 'R V: I C E S R E IQ U IREMEN TS
1 certify that In the performance of the work for which this permit is i55 I shall not employ any person in any manner so as to become '
subject to the orkers'compensation Laws of California. ZONING APPROVED -BY- •T' • -_ '
DATE: •
t—• Date: -•, 16/�J - • signature: lLte--e 1 - - - -. . . _ -
NOTICE:I,ane malting this declaration,you should sublec to the Workers'Compensation provisions of the Labor D U I LD I NG . APPROVED BY _ IDATE
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked: .r , - • ---------'
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED. B Y : ?:• � DATE: OZ'Y6 -9
which this permit issued!Section 3097.Civ.CI. . . . ******'**it************* - *• 3F y •' **** "AFF-R-iE***********'iFF****iF7h '**
LENDER: • *************************1f******{t**3t* . .le************************If******,******
ADDRESS: LEGALIZATION: N -.' ' I-' 'E' E E . ' S M -M A R Y 1 - STRUCTURAL' SEGMENT: N -
.
OWNER BUILDER DECLARATION: I hereby 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 - 35 . 75 •
repair any structure,prior to its issuance,also requires the applicant for such permit to fie a signed statement that he/she Is licensed • 1 y
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business ' P I•AN " • ' s S 0'° - S M I P/NON-RES- ,
and Professions Code)or that he/she Is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by - ' ,
any applicant for a permit subjects the applicant to a civ penalty of not more than five hundred dollars(SSW). ISSUE FEE 4 . 50 .
BUILDING-DIV-> PERMIT• ISSUE PLAN-CHECK TOTAL :
I, as owner of the property or my employees with wages as their sole'compensation, will do the work, and the c, PAID DUE
•
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS---->. - 35 . 751 '4 - 5 0 . 0 . 00 40 . 25 4'0 . 25 . 00
does not apply to an owner of a property who builds or Improves thereon,and who does such work himself/herself or through : t • -;
•
'impis rovemenr her ts sold)within onevided yearr ofthat
competion rtthements owner will e havt e the burden of povingsale.
he/she did not bur ild oe r improve REVENUE DIVISION TOTALS--> • COLLECTED: 40 . 25 OVER/SHORT: 00 ' ,
x for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE .SMIP/TOT GRADING. PLAN-CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 40 . 25
111 and Professions Cede: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • - '
and who contracts for such projects with a aniramor(s)license pursuant to the ContraMors"State License Law))am aware **************************E****************************************************
that proof of their Worker's Compensation insurance should be provided to me. 'I N D I V I- D U A L F E E BR EAKDO 14 N
❑ I am exempt under Section: ' B.8 P.C.
for thisason:• TYPE QTY D E S C R I P T I O ,N ; UNIT COST TOTAL COST
Date: /l[+/4J x"^efa-ae-4I ELE 7 FIXTURES LIGHTING 1 ST20 •
EA. . 75 5 . 25
•
I do hereby c ,ty that 1 ain aware et and understand the requirements of Catilomia Heal h and Safety Code Sections 25505,25533.and ELE 12 R E C EP T/OUTLET 1 ST
25534 and that I or any future building occupant willwlll not(circle one)need to comply with said state codes and the requirements for a ELE - - 4 R E C E P T/S W I'TCLI 1 S 20 EA. . 7. 5 9 . 00
1
permit for construction or modification from the Air Duality Management Distdct.Residential construction applications are exempt from T 2 0 EA, , 7 5 . 3 . 00
these provisions. ELE . 1 SERVICES BELOW 600 V 6 BELOW 200 AMP 18• . 50 . 18 , 50
Date: ApplianL ( •
END OF FEES
. • •
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 •
ordinances and state taws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned _
property for inspection purposes. •
'��•Date: �/V J y a) Signature: ���`t"`k.� - 1 01 000543Q6—D0054306 TOT •
•
40.25
Drivel's License or Sadat Seadry A: • + DATE: 02/16/90 TINE: 15:22
1641-46 White—Buikirlp:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor ' - -- _ • ,
I
.CONSTRUCTION AND PLANNING POO 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 ---
1 3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
S.-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, 0 Undrgrnd. ,
10.-Structural Floor System - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap63. 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 O Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush -
-
24. Roof Framing I ' i - . 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 --11-'•: 78. FIRE PREV. FINAL
30. Drywall Nailing • - - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 7 FINAL INSPECTION
32: Electrical •Power Meter-Final •7/fight FOOD CERTIFICATE ISSUED _
• 33. Final Electric 7//94c.... ..._.4.5
,
34, Final Heating & Air Conditioning , if ,
35. Final Gas Pipe-Test l,} -
- 36. Flood or Canopy - - • ; ' , 7 ' - -
37. Final Factory Fireplace • 11- .
38. Final Plumbing -
- 39. Water Service-Final - •
• 40. Gas Service-Final - , T ' ' - -
41. Solar Domestic-Ficial - , -
42. Backflow Preventer . ,
43. Backflow Irrigation -
44. Landscape Irrigation System _, : ' - - -
45.-Sound Attenuation - -
46. Handicap Regulations - - -
47. FI NAL STRUCTURE & BUILDING -
F+ '
48. FINAL PLANNING - C
- 49:Electric Release to•Edison ,y. '
50. Gas Release to Southern California Gas Co " - c ' ' ,
51. CERTIFICATE OF OCCUPANCY
No. Date
7-
•
PROJECT ADDRESS: 221 E 19TI[ ST UNIT: CITY OF COSTA MESA . BUILDING PERMIT PERM NO: E 046143
4 OWNERS NAME: SANDY WADDELL
A9DAESS: 1430 SANTANELLA TERRACE PERMIT NO: E 046143 • PLAN CHECK NO: N GOVT: •N SUPP: N •
• CORONA DEL MAR
CA 92660 CONSTRUCTION TYPE: 5-N PERMIT TYPE: ELF•. PURPOSE: OTH
•
213-251 .6481 '
ARCHIENOINEER: RICHARD NATLAND • REB.No.:C. 6592 JOB DESCRIPTION : ADD 'REC ' ROOM ABOVE EXIST. GARAGE. • SQ FT: •
ADDRESS: 2418 MACARTHUR BL • • UNIT: 6500 ,
NEWPORT BEACH CA 92660 - -CLAIM VALUE: CALC-VALUE: - . GROUP OCC : A-3 ,/
PERMITTEE' SANDY WADDELL ( 213 ) 251-6481 •
G'Z*fl
ADDRESS: 1430 SANTANELLA TERRACE COMMENTS : REF RE4S?C9 719 •• •
CORONA DEL MAR CA 92660 (<***yt***4******yE**isk****H-x+ ***********H•H********#sr*ys****ares*****aru*sir**r*******-x
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commenting with Section ' ZONING R E Q U I' R E M E N T S
7000)of Division 3 of the Business and Professions Cale,and my license is in full force and effect. S E T B A C• K S , '
CITY UC.: STATE UC.: CUSS:
Date: Signature: MAIN BUILDING ACCESSORY BUILDING ----------
WORKERS'COMPENSATION DECLARATION: Ihereby affirmthat Ihave acertificate ofconsent toself-insure or a certificate of Workers' FRN1': FT IN REAR: FT IN FRNT: • FT IN REAR: FT IN,
Compensation Insurance,or a certified copy thereof(Section 3800 Lab.Cy LEFT: FT IN RGHT: FT IN ( LEFT: FT IN RGHT: - FT , IN .
POLICY NO.: UP.DATE: •
COMPANY: PARKING REQ: PROV : PARCEL: ' 42540418 ZNE: ' REF NO: ,
•• -1 Certified copy is hereby furnished. 0 Certified copy is fled with the city Building Division. PLANNING NOTES> •
• > _ ' . - . -.- . .. . .
Date: Applicant: •
*'**********************************ie**********************.************is********
D IEMPRON FROM WORKERS'COMPENSATION DECLARATION: (Des ' need not be competed if de permit islet one hundred($1°0)a less). DEVELOPMENT ,S E' R V I C E S R E Q U I R E M E N T S
I certify that in a performance of the work for which this permit is t employ any person in any manner so as to become
subject tathe oker 'Compensation Laws oiCagfoma. : ZONING APPROVED BY _._ 'DATE:
Date: 6 J S shou( J 4-4L-1.244( BUILDING APPROVED BY /. - ,
•
NOTICE: t, making this witlon,you snou a ed to the deeWorkers' revoke satbn provisions of the Labor ' DATE: '
Code,y u must forthwith comply with such provisions or this permit shall be deemed revoked. --- , •
CONATRUCTION LEN0ING AGENCY: I hereby affirm that mem s a construction lending agency for me Performance of the work for APPLICATION ISSUED B Y: '1"� �=— .DATE:02.'4 t 0
which this permit is issued(Section 3097.Civ.Cl. - ***************************** ,. 4%� ' ****ie*if******)( '*********************?: '
LENDER: ***********************le***********.x* *************************************ie4(**
ADDRESS: LEGALI7.ATION:N F E £ . S -U M M A R Y • - — STRUCTURAL SEGMENT :N
OWNER BUILDER DECLARATION: thereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC . FIRE SMIP/RES GRADING .
(Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 11 . 00 '
repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed . 5 0$ SMIP/NON-RES
pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she Is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(5500). ' ISSUE FEE - 15 . 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 : PL,AN•-CHECK TOTAL, , PAID DUE
❑ structure Is not Intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL.'----> .: 1 1 . 0 0 15 . 00 0 :00' 26 . 00 26 . 00 . 00
does not apply to an owner of a propend 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 blended or offered to sale.It.however the building or REVENUE .DI VIS ION TOTALS--> COLLECTED: 26 ;00 OVER/SHORT: . 00
Improvement
tthe puprposse sold one year of completion.the owner will have the burden of proving he/she did not build or Improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE ,SMIP/TOT GRADING PLAN-CHECK
I,as owner of me property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business •
26 . 00
® and Professions Code: The Contractors tate License Law does not apply to an owner of properly who bunds or improves thereon
End who contracts for such projects with acontractor(s)Ibense pursuant to the Contractors'State License flaw).l am aware *******************************************************************************
that proof of their worker's Compensation insurance should be provided to me. P ' IND IV IDUAL F E E BREAKDOWN
•
❑ I am exempt under Section: B.S P.C. • '
for this TYPE QTY i DESCRIPTIO N UNIT COST TOTAL COST
Date: /h'44 Owner. 4-...44-42,-44--. ELE 1 'SUB-PANEL • . 11 . 00 11 • 00
I do herebycertify that lam aware of and understand the requirements of Cafi omta Health and Safely Code Sections 25505,25533,and ' - S '
25534 and that I or any future building occupant wli0w •
ill not(circle one)need to comply with said state codes and the requirements fora - END OF FEES .
permit for construction or modification from the Ability Management District.Residential construction applications are exempt from •
these provisions. •
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 ,
ordinances and state laws relating to budding construction and here ulhaire representatives of this city to enter upon the above-mentioned . . . - -
property for iN.__ Date: �inspectio purposes.
•
- �' •
Signature: � •
01 00054305-00054305 TOT 26.00
Driver's License or soda Security A: DATE: 02/I 5/90 TIM: 15:21 '
1841:48 White—Buildirq;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor A
t.
I
CONSTRUCTION AND PLANNING POOL ,PA • -
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 UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation • 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 j
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
I 22. Ducts, Ventilating 71. Product Piping O 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 (Str.ictural) & Monocoat 75: Dry Chemical
27. Frame and Flashing -' 76. Dry Standpipe
28. Lathing& Siding, 77. FIXED SYSTEM FINAL
29. Insulation
4- ;1 78. FIRE PREV. FINAL
30. Drywall Nailing - I' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final80. FOOD CERTIFICATE ISSUED
33. Final Electric 7 Jthe �otes:
34. Final Heating & Air Conditioning 4� • t y f - • • •
35. Final Gas Pipe-Test -',' I
36. Hood or Canopy I / „
37. Final Factory Fireplace I '
_
38. Final Plumbing -•
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
PROJECT AGGRESS: 221 } 7.9TiH ST - UNIT: - CI.TY OF COSTA MESA - DUTLDING PERMIT ,PERt4 NO: BE 045369
OWNEWS NAME: SANDY WADDELL • • ' - -
ApDf1ES5: 1430 SANTANELLA TERRACE • - PERMIT NO: BE.�`?4359 :LAN CHECK NO: 01910-8,9 A GOVT: N SUPP : N
CORONA DEL 'MAR
•
CA 92660 CONSTRUCTION TYPE: 5 N PERMIT TYPE: ELE STR PURPOSE: ADD
rF 213-251-6181 F'T: 2.1.0
ARCN/ENGINFER: RICHARD NATLAND RED.No.:C'6592 JOB DESCRIPTION ' : ADD ' REC ' ROOM ABOVE EXIST. GARAGE. SQ
a ADDRESS: 2418 MACARTHUR' BI, uxrt: 6500 - '
NEWPORT 'BEACH CA 92660 - CLAIM VALUE:' CALC-VALUE: ' 1.9, 217. 00 GROUP OCC: R 3 /
PERMITTEE: SANDY WADDELL - I ( 213 ) 251-6481. _ � ��+-�
ADDRESS: 1430 SANTANELLA TERRACE • COMMENTS : LEGALIZATION WORK ! a'Ik7 '37e2
CORONA DEL MAR CA 92660 • ********************** (*****�E** *x4**x >E** (*-rE*r.****x ***N-*****#*x - x--x-*Ir*******;F**
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N •G R 'E, Q . U I- R E M E N T S
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. .. •
•
S E T B A C K ,S • _
CITY UC.: . STATE UC.: ITL CUSS:
• Date: Signatura:ry MAIN BUILDING ACCESSORY ' BUILDING :
WORKERS'COMPENSIITIONOECLAMTION: IherebyuNiimlhetlhaveaceNfcateofaxaenttosell-insureoracertificate of Workers' FRNT: FT IN' REAR: FT IN FRNT: 77 FT IN REAR :10 25. FT I'N-
Compensation Insurance,or a readied copy thereof(Section 3000,Lab.C). • LEFT: FT IN, RGHT:•
FT I N LEFT: 2 0 FT I N RGHT: 5 FT I N
POLICY ND.: UP.DATE: -
cOMPaxr: - •• PARKING REQ: PROV: PARCEL : 42540418 ZNE: • REF NO:
❑ Ce ifiedcopyisherebytumished. El certified:Oil ed naclyBmldinpDMsian. ' PLANNING NOTES> FOR A 500 SQ. FT- 2 CAR GARAGE AND 500 SQ.,. FT RECREATIONAL R - ,
• >-'ROOM. ,ONLY. . ...
Gate: 'Apphca. - *************************f(**'***1E�:**********************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). D E V E. L O ,P; M E J T S••E'R, V I .0 E S 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 eo as to become '� r'
subject to the Workers Compensation cows ofCatt6ijr . ZONING APPROVED- BY - : 6.. %C ._4----.40tf—_ _ DATE: A.-.41111-,(1/3., .
Date: youre: BUILDING APPROVED BY; : S_" /•f ' • _ DATE': A.VjA-1&'9'
NOTICE:If,after making this •declaration, should/becomevision subject to the Workers'Compensation provisions of the Labor •
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. -• Cs .71 7; ' •
CONSTRUCTION LENDING AGENCY:it hereby affirm thei'there is a construction lending agency for the performance ot'the work for AP PL ICAT ION ISSUED BY: 0 . c - - DATE: / fix,/ fe�_'j
which this permit is issued lsection,3037,,Civ.C). I ' /„ ******-****************' ' �Tr• .• . . . . - •
'6. 47: YlFWWR**********SF:* .*'**. *tr**
LENDER: • ,` / • ***********************W***********'****************************************3e***
ADDRESS: —__ •
( LEGALIZATION:Y - F E , ; S• U •M -M A R Y. STRUCTURAL- SEGMENT:Y '
•
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt fromthe Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC `:•MEC.HANZC/j FIRE SMIP/RES GRADING '
(Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 324 . 00 31- '00 _, - ' 1 . 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 . _ 501 ,' ,SMIP/NON-RES '
---•-• and
to the provisions of the Contractors"State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 52 . 65 '
and Proessions 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 penalty of not more than five hundred dollars($500). • ISSUE FEE • 1 S ••00
I. as owner of the property oremployeeswages BUILDING-DIV-> PERMIT ISSUE PLAN -CHECK. TOTAL PAID 'DUE
❑ structure is not intended or offered for myalSecti7044,Biness and Professional Code: The Contractors' License Law TOTALS--.--> 356, 00 1 5 . 00 J * 26 : 33 ' 397 . 33 3 9 7 . 3 3 0 0
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 _REVENUE DIVISION TOTALS--> • • .COLL ECT ED:0's r 397° 33 OVER/SHORT• . 00
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
purpose of sale). BLDGGRADING PLAN-CHECK .
for the u [ MT PLUMBING ELECTRIC MECHANIC FIRE ' SNIP/TOT
' 324 . 00 . 46 . 00- ,'i'.. 1 . 00 26 . 33
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business - '"` •
and Professions Code: The Contractors'state License Law does not apply to an owner of property who bWds or improves thereon '-�" ):
and who contracts for such projects with a contractor(:)license pursuant to the Contractors'state License Law).l am aware **'*'*'**'****'**'*****'*'****'***'***'********'****'********' ***'******'*******-****** *********
that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A L •-F ,E E B ',R-E A K •D NONNW N "
❑ I am exempt under Section: B.S P.C. . \
forthis reason ' ' ' TYPE QTY D E S C R 'I P T I O N\ .{ " UNIT COST TOTAL COST
Date: I)•-+17-I'7�i owner: �i • 1 • SFR 2'10 OWE-TYPE V-WOOD FRAME • i -GOOD 67 . 70\ '1.4 , 217 . 00
Ido hereby certify that I am aware of and understand me requirements or California xealt ,nd Safety Code Sections 25505,25533,and ELE 1 FIXTURES, LIGHTING /. 1 ST 20 • 'EA. . 75 . 75
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 ELE '3 RECEPT/OUTLET- -' - - i' S4' 10" • �•EA. . 75 ' . 25
Permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. ELE 2 RECEPT/SWITCH ' ' ,,1� ST 20 SEA. . 75 1 . 50
ELE 1 SUB-PANEL I --• J, 11 . 00 11 . 00 -
Date: ' Applicant: Et'ID-DF' FEES ..
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 / v '
•
•ordinances and state laws relating to building construction and here authorize representatives of this city to enter upon the above-mentioned - p. J -,T.
property for inspection purposes. ) ', - '
3 Date: 1241 1Lig signature: ^" • ' 01 00049547-00049550 TOT 397.33
•
Driver's License or Social Security 0: \ - _ DATE: 12/12/89 TIME: 11:58
1041-46 White—Building;Green—Code Enforcement:Canary-Applicant:Pink—Revenue;Goldenrod-Assessor •
•CONSTRUCTIONANDPLANNING POOL. _41A '
Date Inspector APPROVALS Permit# Date Inspector
•
APPROVALS Permit#
•
h 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. /Inca 55. Electrical Bonding
5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
") 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
(((
7. Footings t- ?�' (� 58. Electrical Conduit-Undrgrnd.
4. 5 .
8.-Foundation 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 . I
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final •
12. Sewer C®P 63. Heater & Vent-Finalrf i
13. Roof Drains - - - 64. Plumbing System - Final \
14. Rough Plumbing 65. Electrical-Final- .
•
` 15. Rough Electrical-Conduit 6. Solar System-Final '
16. Rough Electric Wiring `25.G10 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 4 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.cRoof Sheathing - .(10(4d Diti-- 74. Overhead Hydro ..
26. .cBar Ceiling (Structural) & Monocoat 75. Dry Chemical
27: Frame and Flashing �(`R?n D uC • 76. Dry Standpipe - •
28. Lathing& Siding - Z!��/ . , 77.- FIXED SYSTEM FINAL
29. Insulation t :i2r 78. FIRE PREV. FINAL
30. Drywall Nailing • Z( 6 air HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat "; 1- 79. FINAL INSPECTION I
32. Electrical Power Meter-Final I ,, � - ; 80' 'OD RTIFICATE ISSUED r� 9
33. Final Electric .,_ : �;--ti `- .5: I�1(f�O - O'C '� GO
34. Final Heating& Air Conditioning - _ a s 44144`a��,�
35. Final Gas Pipe-Test utit6e
36. Hood or Canopy .{ - a' , d def G2 l ted'a CaL
37. Final Factory Fireplace (�
38. Final Plumbing I ; , t /'_"
39. Water Service-Final ,+ , (�A !, 70�
40. Gas Service-Final 4. <=�%
41. Solar Domestic-Final .
•42. Backflow Preventer
43. Backflow Irrigation -
44. Landscape Irrigation System - ' . ,
•
45. Sound Attenuation - ' , -
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING "1 ig. J18i,
48. FINAL PLANNING ( ; -
49. Electric Release to Edison - '
1
50. Gas Release to Southern California Gas Co :'' •- •
51. CERTIFICATE OF OCCUPANCY -
•
No. Date
•
/rPRwcTADDlkss: 2"21 E 19'IH Si UNIT: - - CITY OF COSTA MESA - BUILDING PERMIT ' - PF:RM NO: G 045370
romMiNAME: ANDY WADDELL // •
,1= / ADDRESS: 1430 9ANTP.NELLA TERRACE • . P17FiMIT NO: G 045370 PLAN CHECK NO: 0'1909 89 A GOVT: N SUPP : N
` CORONA DEL. MAR • • /
CA 92660
CONSTRUCTION TYPE: 5-N PERMIT. TY.PE: ELE MEC. PLU STR •PURPOSE: 'ADD
L-, , IBCH/ENGINEER: RICHARD NATLAND REG.NO.:C-6592 JOB DESCRIPTION : ADD 1ST FLR AREA & 2ND FLR TO EXIST SED SQ FT : 1 ,115 .
ADDRESS: 2418 MACARTHUR BL UNIT; 6500 - • . '
4 NEWPORT BEACH CA 926'60 • CLAIM VALUE CALC-VALUE: 75 , 485 . 50 GROUP OCC: R-3 /
-PLRMITTEE: SANDY WADDELL ( 213 ) 251.-648' -
‘. ADDRESS: 1430 SANTANELLA TERRACE COMMEN • LEGALIZATION WORK ! • - • • '
CORONA DEL MAR CA 92660 ***** **tE**:eine**Ate;E •****+e************* **** ******k************dr*****x*err******
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T S
7000)of Division 3 of the Business and Professions Code,and my license is in lull farce and effect. •• S" E T B A C K S • • i
CITY UC.: STATE UC.: CUSS:
• ' MAIN BUILDING • ----- ACCESSORY BUILDING -
Date: • Signature: FRNT: 2 FT IN REAR: 49 FT IN FRNT: 76 FT IN REAR: 10' FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have acetflcate of consent to self-Insure or a certificate of Workers' LEFT: 3 FT 1N RGIiT: 16 FT IN LEFT: 21 FT IN RGHT: `5 FT IN
Compensation Insurance,or a certified copy thereof Section 3800,Lab.C). _
PCM :
COMPANY: EXP.DATE: I REQ: - PROV: • PARCEL: 42540418 ZNE: Ri REF NOi,
'
Certified copy is hereby famished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> 2-STORY. 2031 SQUARE FOOT ADDITION>
•
Date: Applicant: •
- **************4*********.w*******************7E********************************** •
EXEMPTION FROM WAXERS'COMPENSATION DECLARATION: (Nis section need not be completed A the permit is far one hundred(5100)a less). D E V E:•L, O P' M E" N--T` S E,•R- V�,I. C E ''S= R E Q U I. R E M E N %FT; S
I certify that In the performance of the work for whew this permit is issued,I shall not employ any person In any manner so as to become ..en G._ -_- �g� DATE: / jL
subject to the Workers'Compensation Laws of California. , -ZONING APPROVED BY. (A/-�- L_
Date: Signature. BUILDING APPROVED BY • L� 5 DATE: /4e/y(�
NOTICE:If,atter making this declaration,you should became subject to the Workers'Compensation,provisions of the Labor ,
Code,you must forthwith campy with such provisions or this permit shall be deemed revoked. c• _ // ' l
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for thfpedormance of the work for , APPLICATION ISSUED •B'Y: �.` !,.' - - i i - DATE: /1'
which this permit is issued(Section 3W7.CN.C). ".**************t-*******7iF3C#i WWWgRWR . ' - Cr- ; *** • - ' :3FWFit**********�k'"W-**** W**
LENDER: ,/e( *(**********************************,******** �i**it*******************************
ADDRESS: - •
• - ?LEGALIZATION: Y F E E,;. S U M M A R Y STRUCTURAL SEGMENT: Y- .
OWNER BUILDER DECLARATION: I hereby affirm that tam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELF.CTRJ C- MECHANIC FIRE SMTP/RES GRADING
(Section 7631.5 Business and Professional Code: Any dry of county which requires a permit to construct,alter,improve.demolish,or PERMIT 1 , 063 . 00 89 . 00 . 222 :.00 • 4400. 5 . 28
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 25% 50.%-i.' 2 5% SNIP/NON-HES----1
pursuant to the pmvisions of the Contractors'State License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business P LAN . 172 . 73 , ••• '
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by
any applicant far a permit subjects the applicant to a civil penally of not more than five hundred dollars(S500). ISSUE FEE • - 3 . 00 1'S . 0 0 ?f 15 . 00
BUILDING-DIV-> PERMIT , ISSUE PLAN-CHECK' TOTAL . PAID DUE .
'I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTAL S-- -> 1423 . 28 3 3:0 0 86% 3 7 15 4 2 . 6 5 542 . 65 - . 00
❑
C. structure is not intended or offered for sale(Section 7644.Business and Professional Code: The Contractors'State 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 employees. provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS-2 - COLLECTED.: 1542 . 65 OVER/SHORT : ' . 00 1
,improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
4f0rthe purpose al 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 1063 . 00 92 . 00, 237 . 00 e`. 5 9 : 0 0 5 . 28 86 . 37
e-) and Professimn Cade: The Contractors•State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such Projects with aconuactor(s)Iiense pursuant to the Contractors'State License Law).I am aware 'E***********"***************'H"*******'*******'E******'N'*******``E*********************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL. -FEE BREAKDOWN
o I am exempt under Section: • B.&P.C. . ,
4 for this reason: - TYPE QTY D E S C, R I P 'T I O N- UNIT COST TOTAL COST
Date: IL/It /45 oms: V^ ' .s-ed-t SFR 1115DWE-TYPE V-WOOD FRAME• -GOOD 67 . 70 75, 485 . 50
Ido hereby certify that h am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and ELE 6 RES APPLIANCE 'NPT OVER ' 1 . 0 H P 3 . 00 . 18 . 00
25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a ELE 15 FIXTURES, LIGHTING 1 ST 20 EA. . 75 11 . 25
Permit forconstruction or modification from the AT6ualify Management District.Residential construction applications are exempt fromthELE 39 RECEP'T/OU'EL ET 11 ST 20 EA. . 75 2.9 . 2 5
ELE 20 RECeT /SWI • ` • 7S
Date: _ Applicant: (ELL 1 SER, C S BELOW 60 rV N 200- 1000 AMP- 37 . 50 • 37 50
I hereby Certify that I have read this application and state that to above information'is correct.I agree to comply with all city and county PILL .e 1t At 1 UK 1 L• LK LI?LAC h. -..: .b - 5 U 13 . 00
ordinances and state laws relaurptobumingconswctionand her auUvberepresenuuresofthauytoenter upon the aoe.
ovmentimred MEC 1 INSTALL FORC/AIR FUR ' <= 100 K BTU/H 9 . 00 9 . 00 .
property for inspection purposes. • PLU 4 BACKFLOW PREVENTER , • 2 . 00 • 8 , 00
•
7 mm:" /1/1021 (7-4,4_,„,0„44. PLU 2 BATHTUB 2 . 00 4 . 00
signature: PLU 1 DISHWASHER00556 2 5
Driver's License or saw Security O. 01 DATE: 12/12/8? T 4 T 'YSD42.b.,
Saaa /& STf4LLE1a 12/12/89 TIME: 14:59
te4Use White-BuilElrq:Green-Cope Enforcement;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor '
aQE.�No .P BEST P�oC6's6'E� z2//6/co -
L _ _
_.
- - POOL WA
CONSTIIWCTION AND PLANNING' - Date Inspector APPROVALS Pit # Date Inspector
APPROVALS• ' Permit# _
' Permit
I
, 1. Temporary Electrical Service or Pole , 52. Pool & Equipment Location _ - _
r
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 LIFER 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, 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 J - r
13. Roof Drains /� ///��, 64. Plumbing System - Final
14. Rough Plumbing +1,4 y// y� 65. Electrical-Final -
15. Rough Electrical-Conduit ` 'f("' /, 66. Solar System-Final ' , :Y
16. Rough Electric Wiring .
67. Fencing & Access Approval
•
17. Rough Wiring Sign 168. APPROVED FOR PLASTERING
1 18. Rough Electrical-7 Bar Ceiling 69. POOL/SPA SYSTEMS FtNAL
19. Rough Heating & Air Conditioning Wea.- FIRE DEPT. REQUIREMENT ,•''
20.'Rough Factory Fireplace '!' l "� 'APPROVALS Permit#
f
21. Ducts, in Structure70. Underground Hydro . .
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil ��
a ••
23. Gas Pipe-Rough & Test 72. Underground Flush II
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
, n
25. Roof Sheathing 31i1'6 1&tr74. Overhead Hydro ?,j
26. T-Bar Ceiling (Structural) & Monocoat ; l! 75. Dry Chemical
r
27. Frame and Flashing til1tc:0 40 e 76. Dry Standpipe •
t -
28. Lathing & Siding ' 77. FIXED SYSTEM FINAL \ -•
29. Insulation - I 78. FIRE PREV. FINAL '
30. Drywall Nailing 3. t�. ,of _ ' HEALTH DEPT. REQUIREMENT ; f.. s-
31. Plaster Brown Coat • • � ,r 79. FINAL INSPECTION '
32. Electrical Power Meter-Final ../: ' f -r, - 1 80. FOOD CERTIFICATE ISSUED "I
,
33. Final Electric • 7 '-IC ' ' /, otes: 3/7(4.45_ 0K fri 6472
34. Final Heating & Air Conditioning !�, .3/171,4'` K -�/ Pa ��[ •
35. Final Gas Pipe-Test i3 �. r '1 e /
36. Hood or Canopy1-1.:/i.
r % '. /p lietcgd ',
37. Final Factory Fireplace /l�` it • -
38. Final Plumbing /J�i(/C4ase"`----
39. Water Service•Final I l[eL .
40. Gas Service-Final G ,
41: Solar Domestic-Final •
42. Backflow Preventer - -
43. Backflow Irrigation .
. i '
44. Landscape Irrigation System • .. '•
45. Sound Attenuation
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
tfr"41.
48. FINAL PLANNING - C., •
)
' / „
49. Electric Release to Edison / - r-
c- '
50. Gas Release to Southern California Gas Co '/ -' '%, I 1
-
51. CERTIFICATE OF OCCUPANCY
i
No Date L
-. PROJECT ADDRESS: ; ,x UNIT: . . . -. - . - i - l. . -
OWNER'S NAME:•. . _ .. : . . • ,
• ADD@Ess: ,, PERMIT NO: G 045370 PLAN CHECK NO: 01909-89 A PAGE: 2
- • .************************ *****_***,(4 :-******>E>Esc*****x*********** *********A**coat**
• •t\RCH/ENGINEER: I REG.NO.i _ TYPE - QTY D E S ,C R I P T I O N. UNIT COST, ` TOTAL COST
- ADDRESS: i - , • , •
r .. :UNIT: _
PLU 1 GAS SERVICE 2 . 00 . . 2 : 00 '
• - P RMITTEE: PLL) - 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2. 00 2 :00
ADDRESS: PLU 1 GAS PIPING SYS 5* OUTL,-PER OUTLET : 50 . 50'
• • • PLU 1. SINK, KITCHEN' 2 . 00 2.. 00
•
,LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section PLU ' '1 LAUNDRY' TUB OR WASHER 2 . 00 ' . 2 . 00
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. .PLU 2 SHOWER •" . 2 . 00 ' 4 : 00
•
CITY LIG: STATE LIC.: CLASS: ' PLU 3 .WATER CLOSET ( TOILET) , 2 . 00 6 . 00
Date: • Signature: ' PLU 3 WASH BASIN ( SET) 2 . 00 6 ..00 . 3
WORMERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' PLU 2 WATER HEATER AND/OR VENT ' 2 . 00 - 4 .'00
Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). PLU .1. WATER SERVICE 2 . 00 2 :-00 "
POLICY NO.: EMP.DATE: ; END OF FEES - • - j
COMPANY:
`1, Certified copy is hereby furnished.. El Certified copy is filed with the city Building Division. • _ I - - ,
,.rite: Apolioant: ,'i •-
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). . -
• 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. , - . _ i •
Date:.. Si9�ature: _ . . • - .. .
NOTICE:If,after making this declaration,yoo`•should become subject to the,Workers'Compensation provisions of the Labor • r i
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. , /
•CONSTRUCTION LENDING AGENCY: I hereby afllrm that there is a construction lending agency for the performance of the work for • ' / ' •
which this permit is issued(Section 3097,Civ.'C). , • ` x• . '
LENDER: • )'
- ADDRESS: - — , .. _ • , �. .,.rl• jl.. _ .- _. • . . - .. _ • .
.)
•
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason , _
(Section 7031.5 Business and Professional Code: Any,city of county which requires'a permit to construct,alter,improve,demolish,or ' -, )
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 - - �t
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by T '
any applicant for a permit subjects the applicant to a civil penalty of not more than-five hundred dollars'(5500). ' , „ -'• I ` .
•
I, as owner of the property or my employees with wages as their sole compensation, will.do the work, and the . Y et •
Elstructure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors State License Law - -- ,
does not apply to an owner of a property who builds ocimproves thereon,and who does such work himself/herself or.through - • ' ' - - -'c,
his or her own employees,provided that such improvements are not intended or offered for sale. If, however the budding or t • <' ✓”
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ( C, -
for the purpose of sale). '' •
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,-Business • ' , . A3 •
1:1 • and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon , t`. ; ;i• .
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ' ' 1
that proof of their Worker's Compensation insurance should be,provided to me. . .7-; ,
I am exempt under Section: B.8 P.C. . ,. ) ' t.Elfor this reason: - - ,'.,
Date: Owner: •
i •
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and , ,
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
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from -'f, •? '
these provisions. r '
%1 I
Date: - Applicant: Y'
I herebycertify that I have read thisr,
application and state that the above information is correct.I agree to comply with all city and county ' I
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned " - •
property for inspection purposes. "4 I .
Date: Signature: - I , '
Driver's License of Social,Security M: , , .
16418 White—Building;Green—Cade Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor - - - ..
-6 '
II _ .
t '
CONSTRUCTION AND PLANNING- - POOL A •
•
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 OF ER Grnd. - I LI ' Mit 57. APPROVAL TO COVER-GUNITE
7. Footings 77 58.. Electrical Conduit-Undrgrnd.
8. Foundation 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-Filial
16. Rough Electric Wiring _ 67. Fencing & Access Approval •
17. Rough Wiring Sign - • - 68. APPROVED FOR PLASTERING '
18. Rough Electrical-I Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL -
- -
19. Rough Heating & Air Conditioning FIRE FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace • _ APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil •
23. GasPipe,Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas 0 Oil
i
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat . . 75. Dry Chemical
27.. Frame arid Flashing _ - - 76. Dry Standpipe
28. Lathing& Siding . 4. 77. FIXED SYSTEM FINAL
29. Insulation • - 78. FIRE PREV. FINAL
30. Drywall Nailing - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat _ AL INSPECTION
32. Electrical Power Meter-Final f --;‘,.e....... %.0D CERTIFICATE ISSUED
33. Final Electric i r (�fes: `7#4--t7 F exE�
34. Final Heating& Air Conditioning /�� "`�A
35. Final Gas Pipe-Test 4'•-•..221 -TO ?inset 14'o, Je � 77
36. Hood or Canopy: - d�to 9� .a
37. Final Factory Fireplace .
38. Final Plumbing• . -
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