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HomeMy WebLinkAbout476 19TH ST - Building Permits(714) 754-5273 • Fvc (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, GA 92626 BUILDING PERMIT Job Adaress: 476 E 19TH ST Suite: Vicinity: REAR OF PROPERTY Parcel Number: 42632115 Applicant: RICHARD LIPPARD Adtlress: Owner: STANLEY, GENE R TR Aqdress 491 COSTA MESA ST Zoning: Phone: 714-842-8933 Zip: Phone: COSTA MESA, CA Zip: 92627-2320 Contracta: R E LIPPARD CONSTRUCTION CO Address: 6921 LAFAYETTE DR Phone: (714)842-8933 HUNTINGTON BEACH, CA , Zip: 92647 License: 351335 Arch : Address: Eng: Address: Status: ISSUED Applied: 02/22/2005 Issued: 02/22/2005 ISSUED BY: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 288 S�.FT. PATIO COVER A7TACHED TO THE REAR OF THE HOUSE. ICBO #5580 Plan Check: $54.11 P�rmit: $8325 SMIP Res: $0.50 SMIP Com: $0.00 Qther: $0.00 Inspection: $0.00 Total: $137.86 SETBACKS MA�N STRUCTURE Front 0. 0 ACCESSbRY Front 0. 0 PARKING Existinq: o NOTES: Rear 10. 0 Rear 0- 0 Required: 0 FEE SUMMARY Calc Valuation: sa,000.00 Claim Valuation: S3,000.00 PLANNING & ZONING Left 17- 0 . Right 0- 0 Left 0- 0 Right 0- 0-' � ' � Proposed: �0 � � ;�, ' � ". '_. � �;,�- ; , , . ,�-;i�" _ NOTICE: The work authorized by this permit shall comply with all applicabla handicep access requlrementa under California statutes and related regulations. (Ord. No. 9248, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If work is suspended or abandoned for a period ol 180 days. INSPECTIONS: In order for the work eulhorized under this permit to be considered legal, such work must comply with all applicable codas, and all required Inapeetlone end final epprovel must be obtained. Failure to oblain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 754-5628 taaere (aroo) WORKERS'COMPENSAnON DECLARAnON: - I hereby ettirtn untler penalry ot perjury one of the fdlowing dedarations: � I have antl will mainWin a ceNficate at consem m self�insure tor workers' campensaUon, es pmNded for by sectlon 3700 of the Lebor Cada, br the pertormance of the work tor which this pertnit is issueA. �heve antl will maintain workers' compensaUon insurance, es raqu'uatl hy section 3700 al the Labor Cotle. for tha peAortnance of Ne work for whkh Ws pertnil is iswed. �My workero' w�mpensation Insurance carner end policy number ere: �� carrier: ''S•T,4TE funr� �.Pp1�cy.Numtier:�� tr�lS ooY �ect/on neetl nat be completed 1! the permif Is velued et one hunered eollars ($�00J ar less.) ✓ � ❑ I certity i�et In the performence ot the work lor which this partnit is issued, I ahell not employ any person in any menner so es to become sub�act to Iha workers' compensation lews of Callfomia, entl egree thet II I should Decome subjact to t�e workers' compensatlon provisions of Sectlon 3700 01 tha LeDor Code, I shell forthwith compl wit� thesa r lons. � ADPI can� �.aQ � � .����s a.s t WRRfiIM1TO: FAILURE TO SECURE WORKER PENSATION COVEMGE IS UMAWFUL AND SHALL SUBJECT AN EMPLOVER TO �CRIM�NAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TMOUuAND OOIURE (5100,000). IN ADDrt10N TO TNE COST OF COMPENSr1TI0N, OMNGES AS PROVIDED f-0R IN SEGTON 3%OB OF TME LABOR CODE, INTEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS OECLARATION: I herebv eMrm Ihat I em IicenseO untler orovisic CONSTRUCTION LENDING AGENCY: ol Chepter 9(cammendng with SecOon 7000) af DiWsion 3 oi��g.Buslness enC Professions Code, entl my Iicense Is In full ❑ I hereby eflirm thet t�ere Is a constructlon IenEing egenty tor the peAormence of Ihe work tor which Ihis permlt is issuetl. (Sec. 3097, Civil Cotle). Lendefs Name: Lendefs Address: Signeture: OWNER•BUILDER DECLARA710N5: Date: I hereby eNirm ihai under penalry ot perjury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe Iollowing reason (Sec. 7031.5, Business antl Protessions Code: Any clry or counry which requires a permit to cons(ruct, elter, Improve, tlemolis�, a repair any swcture, prior to its issuance, also requires the apD���m tor such pertnit ta flle e signed statement Ihat he or s�e Is Iicensed pursuent to ��e provislons ot the Camractors License Lew (ChaD�er 9(commencing with Sectlon 7000) of DMsion 3 of ihe Business end Profeulons Cotle) or thet he or she is e:empt ihereirom and the besls for Ihe allaged exemptlon. Any violetion at Seccion 7031.5 by eny epplicant far e pertnil subJects the applicant to a civil penelty ol not more than fve huntlretl dollars ($500).): ❑ I, es owner ot the property, or my employees with wages es thelr sole compensation, WILL DO THE WORK, end ihe structure Is not Intendad or oHered for sale (Sec. 7044, Business and Professions Code: The Contractors License Lew does no� apply to en owner of property who builds or improves Ihereon, flnd who does such work himsetl or herselt or through his or her own employees, providetl that such impmvemenis ere not intended or oNered tor sele. If, hawevar, ihe building or imprwemeni is soltl wit�in one year oi completion, Ne or.ner-builtler will have tha burden of proving that ha or she did not huild or improve tor purpose oi ule J. � ❑ I, es owner of the property am E%CIUSIVELY CONTRACi1NG WIiH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Business antl Professions Code: Tha rnniractors LJcense Law Uoes not apON �o en owner ot properry who builds or improves Ihereon, and who wmrects for such prqect with e conirector(s) licensa pursuant to the Contractors license LewsJ. ❑ I em exempt under sec. Business and Prolessions Cade for this reason: SignaNre: Date: _ Owner ID veAfied by drivals license. ❑ Ves ❑ No Oriver's lJcense No. E:pires: Vedficatlon ot Ownership by (rype ol document, i.e. - properry ta�c blll or deed): DIVISION OF INDUSTRIAL SAFETV VERMIT CER7IFICATION: ❑ I hereDy cently that no excavatlon Ilve (5) or more feet In tlepth Into which e person is requlred to dexend, wlll be ma0e In conneciion with work euthorized by Ihis pertnit, end that no building structure, sceHdAing, falsework, or tlemolltion or tlismantling thereol, will 6e moro then ihirry-slx (38) teet high. (Chep. 32. Grp 2, Art 2, Sec. 341, Tltle 8, Califamla AdmlNstratNe Cotle). ❑ As owner-Eullder, I will not employ enyone to do work which would require e pertnit fram the Division of InCusirial Sefery, es noted ebove, unlau such person �as a permit to do such work Irom Ihe d'MSion. Signature: Date: Divislon ot Indusirial Sefery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUTHOROJITION OF ENTAY: I certity under penalry of perjury thet I have reatl Ihis epplication end state Ihet the Inlormation given is wrrect I egree to comply wlth ell stete lews end clry orCinances reletinp to builtling construction, anA authorize represente�ives ot Ihe Ciry ot Coste Mese to enter upon the ebove-descnbed properry lor inspecUon purposes. I egree not to accupy or allow occupancy of eny builOing au�horized by this pertnit until linal inspection. COpE I, INSPECTIONTYPE Qd¢. 1616 Fixed System Finel Fire P�evemlon 1266 Pod SOa Finel 200 Final Re-Rool 201 Flnel Block/Retaining Wali 202 Final fectory Fire Place 203 Final Sign 204 Finel Demolilion cooe. ixsvecnoxrva¢ 206 Finel Mochanicel 208 Finel Plumbing 210 FinalElectdcal 272 Final Flre Preventlon 220 222 250 Finel Planning Approval Final Slte Final Bullding/Occupency �� .�i�iI.141 ApOi�un1 to fill In all �paces within �aavy EorEer Iinas antl sign all apP�oV��ata Ceclarotions. CITY OF COSTA MESA PER�y T NO. .-p/ TRACT NO. LOT NO. �BLDG. NO.� CONSTRUCTION PERMIT ,, Q �J�S alo 0750 II/19/B2 . ., 23o5p.,T' ' .. 1 - rro�ecc,vaaras � •�.,Jf yTVPEOFCONSTRUCTION �. ' �' � ' .- . � . � �. Owner� �,�/ . f I L' I r, Lc.sA �� PhOn -� 7 � NEW ❑ ADD ❑ ALTERATION . � " � "' Address C� �, .` �%Y � �'REPAIR ❑CONVERSION ❑DEMOLISH ' � - ' � ' ' ZONING REGULATIONS � � � Arch/Eng. � License No. ❑ OTHER' ' Address ' � _ DESC TION OF WORK � A'P' �� ` .CAntfeCtOf � . �� � � ZONE ' '• PLNG. REF. ¢ � - B Phone TVPE OF PERMIT � ' - SE7BAC C 5. ���OP���i'PV LGNE' � � Add�E55' - - - � - ❑ GRADING �Q �FOUNDAT�ON ..�0 STRUCTURAL SIDE VARD . _ � _ ... LICENSED CONTRACTOR DECLARATION ❑ 7ENANT � ELECTRICAL� OPLUMBING. OMECHANIC 9EpFE VA 1 �ereEy a/flrm thal I am Ilcensetl unEer provlsionz of Charter 9(com- - RIGHT � mBnUng with'. settlon 7000) of DlWslon 3.of tne Busineis antl _❑ OTHER"" ' -' Profassloni Cotla, antl my Ilten58 Is In (ull forta an0 e(fect. - REAR YARD (TO'P/L) ' ' " • PROJECT D CRIPTION •. � License Class � Lltense No. dd' _ '- PKG. SPACE REQ. PROVIDED Date - 'Sl9nature � SQ.FT. . ' _ _ WORKERS'COMPENSATION DECLARATION OCCVPANCV_CONSTRUCTION TVPE STREET WIDTH PARK FEES I hereDy afOrm tha[ I nave a certiewta o/ <oosent to salf-insure ora %� �OOO� �� � ZONING APPROVED BV - - DATE - certl(itate of Workers'-Compen5ation Insuranm,�ry a certifietl��copY VALUATION� � .. - SPECIALCONDITIONS: - thereof (Sectlon 3800, Lab. CJ. �� J41/J��Qv GRADING CU. VOS. ACRES ' � P �No. - ComPanY //7 J�/T/�� . ' ' ' __ . .. . . [ tltietl copy Is hereby turnisheE. _, _ REMARKS: . � • ❑ �ertifiea copy Is tHeC wiM t�e Gty BuilCing DIvi5lon. . � - "''- " ' � EXEMPTION�FROM WORKERS' COMPENSATIC)N DECLARATION � _ ' _ � pThii settion neetl not ba completetl if Ihe per�y C 15 for one �untlreG � . . � 1E300) or leu . / " - '-' - ; certity that 3n tne�parformaaca of tne wor �to w�ic� this permi( is . , _ � _ , _ . Issuetl, I shall no emPloy any person a nar so`as Eeco e PLUMBING' •'PLAN CHECK - -- �- - -ELECTRICAL -•- PLAN CHECK - zubject to th 5 Compensation w o nia./ ' Date �� $i9nature � BNTHTUBS � "' SHOWERS - --- -' - � - - - NOTICE: It afler making [�is tleclaration, you shoulG Decoma sub�ect TOIlETS URINALS� ��- - � GENERATOR y 0-1� KW_ 1-30 �cw � tb the Workers' Compensalion provl5ioni of the Labor Cotla, you musl TRANSFORMER � . � forthwith tomply wlth sucn proviSlons or thli permit shall De tleemeA LAVATORIES �OUBLE LAVS - � -- APPLIANCE - 30-50 KW�50 + KW _ revoketl. � � - CONSTRUGTION LENDING AGENCV � � ' KIT. SINKS '� DISHWASHERS •♦ �- - MOTORS 0-1 HP=1d0 HP ' - I hereby afflrm that Ihere is a construction lending agency (or lhe per- SERVICE SINKS . -� �.SUMPS � � - UNC. SOLAR) 30-50 HP 50 � HP " • .� formance of the work lor which t�is permit I5 i5suetl (Seclion 3097 Civ. C.�. - � - - ' FLOOR SINKS " F1.00R DRAINS --•� + - � FIXTVRES � OVTLETS SWITCHES �- - Lentler's Name _ ., , Lentler'S Atltlress " ' DRINKING FOUNTAINS � • -- -- - GASTUBE�SIGNS - .-- -- - - - - OWNERBVILDERDECLARATION - ' ' 'INTERCEPTO(25'- ""-CLARIFIERS' ' ^ " ' POLELIGMTS� � �� � �� � � � I'hereby aftirm inat 1 am exemDt Irom tha Contractor'S Utenu I�w lor t6e /ollowin9 reason (SeCtlon 7031.5 Buiinau antl Prolesslons Cotla: SWIMMING�POOI - -� -P�TRAP � �- �- • - • � - Any city or tounty whlch requlres a Dermit to construcl, allar, POCES METERED- ' SVB � - Improve, tlemolish or repair any slru<ture, prlor lo its Iisuance, also ro•. yyqTER SERVICE• �' - ALTERATION- -� -PANELS � MAIN- -- � SUB � quires thn appllcanl for suth Dormit to Illa a signeE statement t�at he is 1lcensetl pursuant to the provislons o/ t�a Conlractor'S Licenso Law � GAS SERV ICE OUTLETS' '" - " SERVICE -- -- • --- ��AMP . � 1Chaptar 9(commencin9 wit� Section 7000) of Dlvision 3 oi the Buiiness�antl Prd�sions Cotla) or that �e is enempt�thoratrom antl the yyqTER MEATERS BTU OVTVVT -- � � - - --- -� �- ba9• '�r the allegetl axemption. Any violation of 5ection ]031.5 Dy _ am Jicant-/or a permit suD�otts t�e applitant t0 d.Uvll penalty SEWER CONNECTION$ � �- - - � �� . -- � - � - � •-•- �• � � - � � � � Of�, mOre than live hUntlratl tlollars (5500). ❑ I, as ownor ot ihe prop¢r[y, or my amDloyaes witn wages as thelr SOLAR TANK - -- ��COLLECTORS � , - - � � � � sole compensation, will tlo the work, antl the itructuro is not IntenOetl or offeretl for sale. (Sectlon 7044, Buslnass antl Aotesslons Cotle: The ' SOLAR GIPINGSVS.' - ' " ' - ' ISSUE FEE �- - - -- _ Contractor's Licenso l.aw tloes not apply to an ownor oi a O�oOcrty • qPPLICATION APPROVED BY . DATE who builtls or Improves thereon, antl who tloes such'work himsolf or ISSUE FEE -'-' '- 4 M�ough his Own nmployeas, provlG¢tl thdt SUGn Imp�ovaments a�a no� _ Intendetl or oHcretl (or sale. II, however, tha bullOing or improvomant MECHANICAL � PLAN CHECK • ` � � SUMMARY OF FEES � ' � � � Is soltl wlthin ona year ot complollon, lne ownar will have lhe burUen - - o( Orovinq he tlItl'not Dulld or Improve for tne purpose ot sale). - � � BVILDING . '= ^ -, HEATING SVSTEM 0-300,000 BTU PERMIT f� SMIP .� . S I_r� �.I, �as owner of tho property, am ozclu5ivaty mntracting with. qND DUCTING �� --� - j �- ' - • ' ' Ilcensetl contrac[ors to construct lho project (Section 7044, Buslness �300,000 + BTU P�AN CHECK E PERMIT �' antl R'otesslons Cotle: The Contractor's Liconso Law tloes not apply to _ , ._ _.ISSUANCE E an owner of property who bulltls or Improvas [nareon, antl who con- REFRIGERATION � 0-700,000 BTU r PLUMBING E � tracts iromsuch projects with a.contractor(s) II<esned Pursuant lo SVSTEM " - . - -. _� — ' GRADING'E th¢ContrattOr's�IcenSe.Law�. . . •., 100,000+BTU _ 'PLANCHECK E-�" .,L•-� . � ❑ I am exempt u tler Section � //g. 6/y/ . C. ior tnis BOiLERS • BTU� �� " ' EL'ECTRICAI 5' • ' ^ ' s � rGdSon � � ' �� ' � � '" " � - -- � - � � �PLAN CHECK - f MICROFILM § _ Date�� �� �� O �//�Gi.G'rU SVSTEM REPAIR.AITERATION _ f MECHANICAL E �TOTAL FEE 1' ` I hereby cer[i y thal I hava�reatl this applicatlon antl stale that lna above EXHAUST SVSTEM MULTIPLE� _ • . �E55 AD• . information-is correcl agree'to comply wit�•all dty antl munty _ � P1.ANCHECK 'S� VANCEPC S- �- ortlinances and 5[dt¢ 1 lClatlng �c nStfuctlon, an0 hGtlby auth I20 ' - � • . representativez Ot i ty to e r u0o the abova - enN netl � - � , . _ ' '' �" propGrty fo� sp Ct P r FINALFEE 5�3.SO Signature � � Date � ���L . �. .- ' � ' . ' - - .' ... f� Drivers' License or 55 � ' - ISSUE FEE . . . . . _ ._ - _ _ . . . _ CMF 0865-46 White-Builtling; Gnary-AOP���Ent; Pink-Accounlin9: GolOenrotl-Assessor � i _ " CONSTRUCTION AND PLANNING � POOL & SPA . � . ' �i, -' , � Date . Inspector - . ,. . -'' _ • , `� Bete • - � • Inspeetor APPROVALS Permit # APPROVALS Permit �h _ 1.... Temporary Elec[rical Service or Pole_ _ .� � . , , 43. Pool & Equipment Location ' - '- ` " ' - ' ' i ipe-Un rgrn _ - -� _ .. .. . - Steel Reinforcement " ' " ' � ' - �- - learical•Conduit UtilityUndrgrn - .. _ . _ ' - 45: °Forms � � - ' - - - 4. Electrical Conduit-Undrgm _ ' . � - - 46. -Electrical-Bondin `-� - - � � --• ` - � . ... tee . em orce. . ._ .._ - 47.. Rou Fi Plumbin -& Pressure Test - - ' • - ' - -6. -Elec[rical.UFER Grn _ _ 48.. ,APPROVALTO COVER=GUNITE' - - ' - ' ' ' - 7. ootings. - - _ _ . 49. Electrical Conduit-Undr rn - - �' � � ' - �6. �Foundation - - � � � - --- � - � 50:; �� Gas Pi �0 Undr rn, Test � - 9.- Water Rpe•Undrgrn - - - -- � - : . - 51. .Backvua3h�Lines P-Tra ndr r � � � � � - �- � � 10.--Structmal Floor System - : - 52: � ARPROVALTO DECK 1�1:- �Property Sewer Line�& House Connection - - -- -- �^�"` ' 53. "Backwash�& Rece torFinal ' ' � - -12: Street-Sewer Connection� _ . - "-_ _ - - - 54.- Heatei'& Vent-Final ' ' ' � ,--13.- Rough Poumbing - - - + . _ _ .. _ . ._ . , _.:_ _. . - - -- -- -- ' - ------.. . . . . 14. Rough Electrio-Conduit - -- '- - �� - --- "'56: `Electrical-Final "" " -� ' " ' 15. Rough Eleario-Wiring i � -� --" ' - -' - � -"�"- � - - 57- Solar System-Final - - � ��" � � " ' ' ' � � "16�.�- Rough�Hea4ing & Air Conditioning -` ---- -� - -__ '� � - --- ' •--�' encing�& Access ACProval , 17:' Duc[s in Struaure � - - - - -.,�r,- , ' - AP.P.ROVED FOH PLASTERING , `,'- � 18. - Duc[s; Ventilating - - - - - - - - - -� -- - - - - � ; - - - - - - .- -. . . . , 19. Gas Pipe•Rough & Test - �-- - - -- � 6U• - ?OOUSPA SYSTEMS FINAL, .'. ,, , , , ' ' 20r;- Roof�Framing - - - - - � -- -- . . - - - - - . - - . .... -- - -. r: . . . . . , '.� . . 21.' RoofSheathin - --- --� ----- � - -�----� ---- - '^"'' ''�� - . 22:. -prame and'Flashin -.- - '- -- - ' -' - - - . �.NOTES: - ." . '_ - . - � . , � ' . -. ; � .. . ' ,. ; 23.' losulation- -- - -- - - ' 24. -Lathin & Sidin -- - - - -- � - -. --i '- -- . .. ��- - - - �--- . . . .. � : . .. �, _ . .. - - - - -' _ ' ' --- '- 25.-: DrWvall Nailing � - . _ ... . ._ _ . _ .,. . . . . . ... . . . � . . . �. .. 26. -Plarter Brown Coat � ' - - - - - - - . � . . � . . . . - . , _ �, ' �27.' Electrical Power MMer-Final .. - - - -S - - _ -: -. - - - - - - • - : . ' . Y . �. �. .. � � .. ', � 28:�--Final Electric - - - - - - - -- --- -� .. - - � -- - -- � ' . . , 29.; - Final Heating & Air Conditionin9- - - - - y ... . . � - '- - .- - - --.. .. . - � . . � � . . : 30:' Final Gas Fipe•Test • - 4 - - 1•- - - _ _ _ .__ •" � 31.' Final Plumbing- - - -• _ . �,'327 Water Service-Final -- � .- , - --- -.-- - - - ' . �. 33. TGas�Service-Final-- - - - - ' � � � � � ' ` � � � 34. Solar pomestioFinal ' � '_ � ' -•' � ' � � � � ' 35.-" landsca rinklin S stem- � ' -- - ' ' ' , , 36. Sound Attenuation ' - -- � ' � � � � - � -� ' 3�. Handipp Regulations - •-- - p ' � � , 38. PINALSTRUCTURE&BUILDING "-� _�=�: . ` ' � BC ' 39. Special Requirements Completed �' ; � � - ' � - �- '- � ' " " � - 40. Electric�Release,to Edison ; �' � � � ' - �" '� ' ""' � 41. Gas Release to Southern Califomia Gas Co. � � � • ' ' � "�" • � � • � � • • � � �.,.,,. ; 42... CERTIFICATE OF OCCUPANCY � --i � • - � - - --- . __ . , ' � . '" ... .',• • � ' ,'.<. . . rNo' Date � � - , ---- - - - - - - - - - - - . . _ . . , . . , Aoo��hant to fill in a11 soaces wit�in heavy boraer lines antl si9n all apo�ooriate Aecbrations. � •-� CITK OF COSTP_ MESA PERMIT NO. . TRACT NO. LOT NO. BLDG. NO. ..__ . _ _ .. • CO,jV�TR,JCTI�NPERMIT �—ySS9 � '� � 6434 `B/2DY82 � 262.89 T " Project Address ' �G _ � � �- TVPE OF CONSTRUCTION �; ' � ' " " ' , , , . � Owner � V + L ) Pho� /ii� ❑ NEW � ADD ❑ ALTERATION � - - . . � � Addfe4. �,' _ � � ��� �' ❑ REPAIR � CONVER510 ❑OEMOL SH � � ' � � . - - - -- ZONING REGULATIONS � - - ArCh�Eng. l:iCense No. ❑ OTHER ` A P# , ,_ Address _ _ , DESCRIPTIONOFWORK ' � � 1JZ � S- -_ - ' - ' ' " - ZONE - PING. REF. � . ��Contracror - � _ Phone. - TVPEOFPERMIT - . ..� �- � -- - aR�,U Ik.DINGT?Moa3C � 'll SETBACK C ST.�� 5 I 3 � AddI255 � - � ' �-- - _ _- _ . . . . _ ' .Q GRADING -. ❑ FOUNDATION .O.STRUCTURAL_ . t51DF VARD. . �'Q � _ _ _ , -LICENSED CONTRACTOR DECLARATION ❑ TENANT'O ELECTRICAL OPLUMBING ❑MECFIANIC SE�� A �_ �� .1 hereby af(Irm tnLt I am Ilcensed unq¢r Drovistons o( Cnarter 9.(com- - . . _' R T - -' inentin9 •wilh sectlon. 7000) oi -DlyiSion 3 of the Busineis antl -❑ OTHER • � " - Prof¢i5ion5 Cotle, antl my Iicanse is In fulP force antl effect. � '- - " ' ''- REAR�VARD(TOP/L) L -- -� � �Llcense Class' ' - ticenm-Mo. - PROJECT DES RIPTION' � :,r •jQG /� . �. ' -- - , SQ.FT. 5 - /S 7PKG.SPACE RE�.-- -� -�PftOV1DED. - I Oate ' -'" S�9�ature L ' ' " ' ' �%� STREETWIDTH - - PARKFEES--��� f WORKERS'COMVENSATION DECLqRATION OCCUPHNCV" - CONS^RU 1q TVP� . ��! �. - 'ZONINGAPPROVEDBV- DATE I hmeby alfirm t�at I have a CerUBCdle of con5ent lo salf-Insure or a VALUATION -20N� ����'" : . du�: icortHiwta ol Workers' Compensatlon �nsurance, r a certlllea'copy � . .. . � IhlrCOf Section 3800, Lab. CJ. " - � ' " ' - ' - '�SPECIALCONDITIONS: � - ( GRADING CV. YDS. ACRES � t+�qcY No. - . .ComOany %�/L �/%�/z� .' ' ' I brtifletl copy ii.hereby turnishetl. • REMARKS: � I V � Je/lifietl COpy IS filetl with Ih¢ City Builtling OivlSion. � � - - �-- E%EMPTION FROM WORKERS'{OMPENSATION�DECIARATION � � �r � = I S : . Gl �• (This 5ettion nee0'not be completetl If tha permil Is for one nuntlreE � - IS300)or-less�: � .._ . -- __' "_'" ' " : . � _ _ ' ,iP, 't.� 1 .l•:' " " I certliy thai n tbe per(ormance of tq¢ rk t nicb thi p¢rmit is '. Isiuetl,- I sha nOt mPloy any person I ny r•so a mme PWMBING --` -� �PLA�v CFIECK - �.�EIECTRICAL - �-- PLAN CHECK . �' Dat'e ct to� ��yo . %L 9nature tlon s n .• - � ^ ' " ' ' " � BATHTUBS- ^- SHOWERS "� NOTIGE: II af[er making this tletl5rat�on, you shoWa become subject �T,OILETS URINALS � - _ GENERATOR _.Od�KW_�1d0 KW � :- f0 th0 WOfkBfS' Comp8115dtiOn prOVlsiqps of lhe 12boI Cotl¢, yoU TOst � � � � , .TRANSFORMER � ..� _ forthwltM1 comply with such provl5ion4 or this permlt shall be tleemetl LAVATORIES DOUBLE.LAVS. . .�APPLIANCE 30,-50 KW_50 � Kw" - CONSTRUGTION LENDING AGENCy - - -` -' • ' KIT.�SINKS -• • -� DISHWASHERS• . ,�MOTORS_.. _ . .0-1 HP_3-10 HP� � - ' � I hereby affirm [ba[ tnero Is a constructlon lentling agency tor Ihe per- SERVICE SINKS , .SUMPS-. � -� • _ _ PN�• SOLAR)__.30-50 HP 50 + HP �• formance oi the.work lor whlcb lhispermlt is Issuea (Section'309]. -- - � - , Civ.-C.�.'- �� '+- -- •---- - __ _ ' T'1 ' �' � � FLOOR SIIVKS � -FLOOR DRAINS�.� �FIXTURES 'OUTlETS. �.SWITCHES . � iLentlor's Name �' - � �lentler'SAtltlresS � "' '�-- "' � ORINKING�FOUNTAINS----�- �- - p - GASTUBE.SIGNS _- . OWNERBUILDER DECLARATION- •' "� -� ` °" " � '��NTERCEPTORS - L CL'ARiFIERS�-� � � -� -�POLE.LIGHTS .�. �._` __ r_ ' __ _ _ I hareby atfirm t�at 1 am ezemp[ from [he Contracio�'S License Law tor - � ' the-Pollowing rcason. (Sectlon' ]031'.5 Business antl Pro(es5ions Cotle: .SWIMMING�POOL ---P TRAP.. --- rS �POLES - ----METERED= r SUB � � Any city or: county which requires. a permit to consirucq alter, ' . � improva,�tlamolish or repair any structure, prior'to its issuance,also.re-. yyqTER SERVICE"� •`=AITERATION':. �- �- � �PANELS -- _ MAIN _._ _ SVB �': � qWres the ap, 11�'ant foLsuch permit to tile a slgned,sta[emen[ that he is IlcenseU pursuantto�the provisionsbf the•ContractorJs License Law' "GASSERVICE � - �OVTLETS - - -- � � �SERVICE. __ . _. '_�AMP_ _ 1ChaO�er 9(commencing witn Sectipn 7000) oi �ivision 3 ot tne -� Buslnass�antl Prdessions Cotlaj.or that he.isexemptthere(romantlthe yyqTER�HEATERS � �BTUOUTPVT -. ' _. . . . . ' i ba{�I5 for the allegetl exemption. Any violation of Sectlon 7031.5 by awb�T'., pPlifvnt for a permit sub�ects the.appliwnt to a civil -penalty SEWER CONNECTIONS - - - - - . - . _. _ ._ _ _ . �. _. _ � _ '� �� .� - -- �.-".�'Y�?^M1 , more lhan live huntlretl tlollarf (5500). ' , , , , �� . � e_t^i::;a5'owner'oi the property, r -SOLAR�TANK- - ---COL'LECTORS . - -- -,-. - _ _ will 40 lno work, dnU the 5tructurB i5 nOt Intentletl - �' or ofler�stae."(Sectlon 7044, BUYlnoss antl'Aofe55ions Cotle: The SOLAR PIPING SYS. - - - � ISSUE FEE . bonlratlor's Licenzo Law doe5 not apply [o an owner of a properly . APPLICATION APPROVED BV • DATE ' n- who bulltls or improves thereon, antl wno tloes such work'himzelf or ISSUE'FEE' ' '' '- " ' pl. �throu9n bis own employee5, provitletl tbat such improvements are not , � intentlea o7offeretl tor sale: Il, nowever,-the bultaing orimprovement MECHANICAL �- -�� PLAN CHECK -' - ''' SUMMARV OF FEES -' " is soltl within one year ot mmplelion, �he owner wi�l �ave t�e burtlen ' . BUILDING ��^�j� � � �' � �' � of'proving no GIO noc'"bu110 or Improve for t�e-purpose�of saie). HEATINGSVSTEM 0-100,000BTU � �PERMIT S_{.7�.?=7,� SMIP � S "r'y U.,- ,�_I, as _owner a/ [he. property, ary� exclusively contracting_wi[h AND DUGTING --- -- - - � ' � �' - . � � licensetl contractors to conzVuct the project (Section 7044, Business 100,000+BTU � ,PLANCHECIC E�-� - PERMIT antl Professions Code: The. Contractor's License l.aw tloes not appry to,. , � i55UANCE S" an owner ot propMty who builtls or Improves thereon, antl who con- REFRIGERATION 0-100,000 BTU � -PLUMBING' S -- � "- i `� tracts Irom_sucn_pro�ects_with_a contrattm(s�.Ilcesnetl pursuant to _SYSTEM ��'GRADING �5 tne Conlraclor'S LJcensc Law). 300,000 + BTU ' ' - - PLAN CHECK 5 ' -' " '� ' _-� , ' " ' . ❑- I am exempt unCer-Section � 8. 6 P. C. tor this � BOILERS - - BTU ' � � ELECTRICAL S�,�_ � - 1- - s�-- - � raamn � n /' �� . _ PLAN CHECK S MICfiOFII.M S�� p Dale Z O SYSTEM REP{11R, ALTERliTION , - SOTAL FEE S•�%�6� I hereby ttrtity lnat I have reatl Ihis application antl 5tate Ihat the above EXHAUST SVSTEM MULTIPLE � � �' -- MECHANICAL_S _ PLAN CHECK .E. " �� VANCE PC, S_ Informatlon is correct: I' ree-to <omply wi[h a1P city an0 county- -- - - orGinances antl state laws tlng to ❑SlructlOn, dntl hereby dutho Ize � �, , - �- repreSentatives � t 'to e l�r upon Ihe above ¢nti etl - ' ' � Q property tor i et r u D Signature Date-Ei��_ ' ._ . . FINALFEE S_�a(J� ' Driver5' License or 55 � � � ISSUE FEE . _._ , __ . . .. , . _ .... _ _ _ . _ _ CMF 0865-J6 WHite-Builtling; Unary-Applicant; Pink-Accountin9: Goltlenrotl-Assessor ' � _ , � .. ' {,. CONSTRUCTION AND PLANNIN ' -. , � POOL & SPA , ' , . '� , Date Inspector , _ � 'Date - I spector ��'} APPROVALS Permit# �� APPROVALS Permit# 1. Temporary Electrical Service or Pole _. . . 43... Pool & Equipment Location '•� �- �- . Soil� ipe-Un rgrn - .. - 44. Steel Reinforcement � - - ' ' 3. Electrical Conduit Utility-Undrgrn � -- 45. Forms � '-' ' � 4. Electrical Conduit-Undrgm � � � � g�y LD - 46. Electrical Bonding - - -- � ' � . tee e�n orce. - ^ . . � 47. Rough Plumbin & Pressure Test -' � ' ' - � "" - ' 6. Electrical-UFER Grn - . " - ' -- . - 48. .APPROVALTO COVER-GUNITE '- -" ' - '-" ' " . /0 -!'LFi - - 7. � Footings - - � - _ . � 49. Electrical Conduit-Undr rn B.- Foundation - - - ' - - - - - - - ' 50: � �Gas.Pipe, • � Undr in, Test � ' -' �� ' 9- Water Pipe•Undrgm• �- - -� - - 51�.- Backwash Lines P-Tra ❑ ndr�m � 10. StructurolFloorSystem � -- . ,,. 52. APPROVALTODECK � � 11.' Property Sewer Line &-House Connection - - -� 53. Backwash & Rece tor-Fina( '� � 12. 5treet Sewer Connection - --- -- � 54. Heater & Vent-Final 13. -Rough Plumbing ' - ' ` � � � - - - - � � � 14. . Rough ElectricConduiY � � - -56. Electrical=Final -" ' � 15. Rough Electric-Wiring �(� - 57: Solar SYstem-Final . � - � � ii • 16. Rough Heating�&�Air Conditioning - ' - ' - - - � � � • encing & Access Approval � . . . ,17. • Oucts in Structure � t • � APPROVED FOR PLASTERING ' �- 18. Ducts, Ventilating � - -' ! - � • - - - � � ' • - . - � . 19. Gas Pipe-Rough &7est � � - - - ,60• POOUSPA SYSTEMS FINAL � •� . . - - � 20. Roof Framing � - - • � � ' 21. RoofSheathin ��-�$-8 ry✓1 ' � - , �,�_�' ` ' ' ." d ' 22. FrameandFlashin ,-�-r� �. _ �y✓( NOTES: �' � �� � �:, ,��. A .�j '� 23. Insuiation - - (/-(iJ�`f� 'Y✓� --Q n . - " p c 24. ' lathing & Siding ' I - 3$� ' -G ' N " � S' - 25. Drywall Nailing �/- ' _ ,1 - ��-14'S:L . 26. Plaster Brown Co t - 1.,p - - � 27. Electrical Power Meter-Final - - - - � 28. Final Electric ' - �a-1�'$ C:� - - - ' ' 29. Finai Heating & Air Conditioning • �� � � 30. FinaLGas Pipe-Test - - - 31:' Final Plumbing � � - - - - . � � � �� - _ . - ' '32' Water Service-Final � . - � - - �- - � . 33. Gas Service-Final' � � � - - �- � - � � � 34. Solar pomesticFinal ' � � � ' ' � � � - ' 35. Landsca e S rinklin S stem" - � •� ' � - � � ' �' 36. Sound Attenuation ' � - - • • - � � � ; 37. Handicap Regulati6ns ' - •` ' " - � - � ' 38. FINAL STRUCTURE & BUILDING ' z_ . _$ " - � � 39. Special Requirements Completed ' - - - � - - ' � �40. . Electric Release to Edison ' • 41. Gas flelease to Southern California Gas Co. ' � � � � �? CERTIFICATE OF OCCUPANCY - - ' ��� �No. ' Date � � .. . _ . .._ .. \ . . . . . . .. - - -- .- . . . i _ - ' Applicant to lill in all ipatts wilhin heavy borEer linei antl si9n all approDriate Eeclanlions. BB39 I U/l7]/82 I`2e�� , T ' CITY OF COSTA MESA P�y�r,, NO. "" TRACT NO. LOT NO. - BCOG. NO. ' ' -"�' ' ' ' - ^ " ' ' ' CONSTRUCTION PERMIT r��'� '�SD9D - . ' � � ' • +''.' '' Project Address ' � r' ` �. TVPE OF CONSTRUCTION � . . � . . . � � '- - Owner I [• L�J i r' Phon D ❑'NEW ❑ AOD �❑ ALTERATION . . � ��.•' . . � "' . .. � � , . , . � . Addiea �� � � � � ❑ REPAIR ❑ CONVERSION ❑DEMOl15H .- Arch/Eng. � License No. ❑ OTHER" � � � ` ZONING REGULATIONS 1j DESCRIPTION OF'WORK � A'P' � ' .;• ' Address ' � - - -� - � � • � - - � ZONE ' PLNG.•REF. •� l � Contrector � � Phone - "-TYPE OF PERMIT - ! � � � � �� � - ' � - ' �� ����$�N� - ' 1 ' SETBACKCLST. O V'LINF . � `� Addf255 -, � ' ' " ' ' - ' •O GRAOING �' O FOl1NDATION - � STRUCTURAL' IDE'VARD - ' - ' ., -' _ �LICENSED� CONTRACTOR DECLARATION ` -� TENANT O ELECTRICA6�OPWMBING-�MECHANICA � 5EDFE YH ' - - � ' - ' -' I hereby altirm Ih6t I am IlcenieC unCer provislons of Charter 9(com- � � . , RiGH7 � � � �mencing 'with �section 7000) oh; Division- 3- of the- Business antl �❑ OTHER�= ��� � - . � Protessions Cotle, antl my Iicense is in full force antl eifeci. • � REAR VARD (TO P/L) " .PRO�ECT�DESCRIPTION . ` _ _. .� �LitenSe Class License No. � ' . - , � � � � • - �) ` � ' �y PKG. SPP.CE REQ. ' - " PROV IDEO Dzte � Si9natuie' ' . . . . . SQ. F7. � '�.._ _' ..... - . _ . . . _ ._ WORKERS' COMPENSATION DECLARATION. � .. . �-0CCUPANCV •-=CONSTRUCTION TVPE, � STREET WIDTFi .� PARK FEE b � I hereby affirm thzt I have a certificate o( consent to ulf-insure�or a VALUAtION "'• � ZONE � � ZONING APPROVED BV -, - ; �Certiticdt¢ o/ Workers'.Compensatbn.InSu��d +Ce, op d Certifle0 copy� �-. _ _ . -�� • . - - ' �e `� YSPECIALCONDITIONS: � I � thereot (Sectlon 3800, Lab. C.). �'r //. n��� GRADING CU. YDS ACRES ' _ ; _ 'cy No. Company �r� N/Tsc ' �_ . . . .� ., ... _ .._ , . . . ... . ertifietl copy ISbereby furnishetl . . . . . . ..... . . REMARKS: " �' �' � ' � � � �? � " Certifletl copy is fiietl witM1 the city Builtling Division. ' . EXEMPTION FROM WORKERS' COMPENSATION DECIARATION - - - ' ' ' - ' � (Thls section neetl not be comple[etl i[the perTit is f0/ OnE hundr¢a �� - -, . - _ , , _ _ __. . _ . , _ _ � �� _ • SS1001 or less�. �7 ,. . . � . . . . . _ . cart(ty tnat n t e pertormance of the work Or which t is permit is .�- � Issuetl, I shal no employ any perso Y �nner so S be¢ome PLUMBING �-_ �µPIAN CHECK '' , ELECTRICAL ' ' ',PLAN CFIECK . � subject to h W s' Compensatio v o I to i. � Date G �Si9naturg��'��ES��� -BATHTUBS � ` SHOWERS � � " ' �� - .. � - ' ; ��NOTICE: It a ter making this tleclara[lon, you shoultl become subject 'TOIL.ETS .� • ��URINALS- "'_ " - �GENERATOR 0-1 KW_ 1-ib KW . to the Workers' Compensation provisions of tne Labor Cotle; you must - �TRANSFORMER - � forthwith comply with such provisions or this permit zhall be tleemeC LAVATORIES DOUBLE LAVS � ' -"APPLIANCE 30-50 KW=50 a KW `� _ revoked. . �� � . ICONSTRUCTION LENDING AGENCV � KIT.SINKS " "DISHWASHERS' � "' � ;MOTORS � 0-1'HP_1-30 HP� Iherebyatfirm[hattnereis.aconstructlonlentlingagencyfortheper- SERVICESINKS .,SUMPS � � ' � -(�NC.SOLAR) 10-SOHP_SO+HP . i 'formante of [he work for which this permit is issuetl (Sec[ion 3097 Civ. C.�. � . . - FCOOR SINKS � FLOOR DRAINS - 'FIXTURES � ' OUTlETS ^ SWITCHES � �Lentler's Name ' �LenGer's Atldress � � -DRINKING FOVNTAINS � f ` �� �� ` �GASTUBESIGNS - - ' . � OWNER BUILDER DECLARATION- ' � INTERCEPTORS � CLARIFIERS ' ' � ' •POLE LIGHTS � ' ' I hereby affirm lha[ I am exempt irom the Con[racmr'S License Law for � � the tollowln9�reason .(Section 7031.5 Business and Rotessions Cotle: SWIMMING POOL "'PTRAP'�� ' �� � ' 'Any city or county which reqWrei a permlt to construct, alter, �701E5 -METERE� -SUB�' improve, tlemolish or repalr any sVucture, prior to its issuance, also re- 'yyqTER SERVICE� -�� ALTERATION� - ` � PANELS - MAIN �-SUB . - quires the ap,.licant for such permit to file a Si9nEtl Sta[ement that he , Is Ilcensetl pursuant [o the provislons ot the Con[ractor's License Law GAS SERVICE OUTLETS � U' .SERVICE' " ' ' AMP� ' (Chapter 9(commencing with Section 7000) of Division 3 of lhe , Business antl Professions Cotlepor t�at he is exempt therelrom�antl the WqTER REATERS '- BTU OVTPVT - ' - -� �' � � � b�"' lor Ibe alle9etl exemption. Any violation ol Sectlon ]031.5 by r ppliwnt for. a permit sublects the applicant-to a Uvil penal[y SEINER CONNECTIONS " " - - � � � � � � � � � � �' � i more than five huntlretl tlollars (E500�. _ , , Ll i, as owner of t�e property, or my employees with wage5 as their SOLAR TANK COLLECTORS � . � � .• ' ' � � • sole compensation, will tlo the work, antl the structure is not intentled , orofferetl tor sale. (Sectlon �044, Business antl Rofessions Cotle: The SOLAR PIPING SVS.' �' � � � ' � - ISSUE FEE' � � � Contractor's License Law tloes not apply to an owner of a property . - . -• . - APPLICF�TION APPROVED'BY .DAT Q who builtls or improves ihereon, antl who tloes such work nimsali or ISSUE FEE ' ' throu9h his own employees, provitletl that such,improvementz are not ' � ' Intentletl or ofieretl for sale. I(, however, the builain9 or improvement MECHANICAL' �� PLAN CHECK' �� � SUMMARV OF�FEES Is soltl within One year of cOmpletion, t�e owner will hdve lhe bu�tlen - . . . of proving be tlitl not builtl or improve (or [he purpose of sale). HEATING SVSTEM 0-300,000 BTV PERMIT G E SMIP : b--- � ❑ 1, as owner of Ihe �property, dm ¢xtlusively conVattinq wilh qryD DUCTING �G - �' - � � � �-� Iicensetl contractors to cons(ruct the projece (Section ]044, Business 100,000�+8TU � �� (/ 'PLANCHECK S---AAA------���.� PERMIT _ antl Professions COCe: The Contrac[or's Litense taw Ooes not apply to -,�, rt�( , � ISSUANCE �.S an owner ot property who builtls or improves tbereon, antl who con- REFRIGERATION 0-100,000 BTU ,PLUMBING 5��- tracts trOm sucn projects� with a contraCtor s) Iicesnetl pursuanf to SYSTEM � 100,000 �t BTU' � ' P�AN CHECK E � GRADING' S� the Contractor'z License Law�. . • . $ • ' ❑ I am exempt untler Section n & P. C. for this BOILERS � BTV 1ELECLiiICAL 5 �' � - r¢a5on � �� /l ^' ~ �� �' � � PLANCHECK"�$ ' - � MICROFILM�E � Date 7 y O • ' � SVSTEMREPAIR,ALTERATION TOTALFEEy. ;MEGHANICHL f ��� • � � I hereby certifythat I have read fM1is appliwtion antl state thal the above EXHAVST SVSTEM . MVITIPLE _ , LE55 AD- �� ' information is wrrect. agree to comply wit� all city�antl county PLANCHECK E �VANCEPC S_ � Ii ortlinances anE zta[e la relatin9 construction, antl hereby ut rize �' �. �. �� representatives f a ty tb �[ uPo the above en onetl � �� � y_ �� ' � -"• T prOp¢rty for p A.7 ��Z , .' FINAL FEE�$/ `�v SlgnatUre � Date �� � _ Drivers' License ar 55 � � ISSUE PEE , a' rnec naas.nF wnua.a�a�d�ne� r narv-aooliranh Pink-Accountin9: Goltlenrotl-Assessor '' - - � ,� � -,. � •. � CONSTRUCTION AND PLANNING � POOL & SPA ' •�. , APPROVALS Permit� Date �^gP�a� APPROVALS, Permit•# �� ��� � �ate. .-. . Inspector • 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -� •• - • ' i ipe• n rgrn � ' Steel Reinforcement - lectrical Conduit UtilityUndrgrn 45. . Forms - - 4. Electrical Conduit-Undrgrn - � _ 46. Elec[rical Bondin - - - � tee em orce � -- . 47. Rou h Plumbin �& Pressure Test � 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. ootings 49. Electrical Conduit-Undr rn ' ' ._8. Foundation 50. . Gas Pi ,. ❑ Undr in, Test � 9. Water Pipe-Undrgrn 51. Backwash ines P-Tra ❑' ndr rn � " 10. Structural Floor System 52. APPROVALTO DECK '" - 11. Property Sewer Line & House Connec[ion 53. . Backwash & Rece tor-Final 12. Street Sewer Connection - ' � 54. Heater & Vent-Final � 13. Rough Plumbing - � ' 14. Rough Electric-Conduit - - � -- ��56.� Electr�ical-Final ' 15. Rough Electric-Wirin � - � - - � - 57:-- �SolarSYstem-Final � � " � 16. Rough Heating & Air Conditioning . • encing & Access ApProval - 17. Ducts in Structure � ' APPROVED FOR PLASTERING , i��: '� - '- � 18. Ducts, Ventilating . � - - . . ' . � _ 19. Gas Pipe•Rough &Test , Jo..�L- 60• FOOI/SPA SYSTEMS FINAL 20. Roof Framing � - � 21, Roof Sheathi � ' 22. FrameandFlashin �NOTES: � ' - 23. Insulation � /%-/j'-8�Z T- s� T. 24. Lathin & Sidin • ' ✓ ' 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter•Final � � � 28. Final Electric ' � � �� ' � 29. Final Heating & Air Conditioning - ' � 30. Final Gas Pipe-Test /j�y ' ; _ 31. Final Plumbing Y.._ � 32. Water,Service-Final. _ " ' ' - - 33.-. �Gas Service=Final � ' - 34. Solar pomestio-Final � � � � ' 35. Landsca S rinklin S stem " 36. Sound Attenuation � � � � 37. Handicap Regulations � 38. FINAI STRUCTURE & BUILDING ' � 39. Special Requirements Completed' ' � � " ' ' ' ' - ' ' 40. Electric Release to Edison - � ' ' " ' "' • " ' ' ' -' �' 41. Gas Release to Southern Glifomia Gas Co. � - � � �� 42. CERTIFICATE OF OCCUPANCY . _ ' � � . , , . . � ',. � . No - Date � ' - - - . _ AGO���ant to fill In ill ipaeas within heavy Eortler lines anE.sign all aDProD�ialo Aeelantions. `\ � CITV OF COSTA MESq PE I�Tr+ O. TRACT NO.' LOT NO:� BLDG. NO. - -�- - - � CONSTRU�TION PERMIT L � .2�DG __;. . • = '`� �•�,, �,. . ,,il - . ' �Project Address ,�.�, — %, TVPE OF C,�O(NSTRUQTION. . � ' � � l'�� . �i ,��� - � .•. '1 , Owner � �� ��T �Phan (' � ❑ NE1N J[aADD -��OALTERATION � ' i�. 9R +�_ �.. ; Addl2a ;r-/�GJY . . _ �OREPAIR ❑CONVERSION���DEMOLISH ,_ �''�'� ��� ��'�" `� ��•r � `Arch/Eng. � • . � �License No. . � �O OTHER ' � � ' I �� t -ZONING REGULATIONS l •1, ,Addfe55 � ' � ' - - - . . . DESCRIPTION F ORK �� 'A'P'�. ��T�� �� y�^^' � �ZONE - � ' BLNG. REF.,$�'- Contractor �' : " �• . G'j . � ' Phone - � TVPE OF PERMIT � - ' � B � - Tpg�/ i�oiNG - - SET ACKC PROPERTVLINE ' - :Addf2ss - � - " . • ' . ❑ GRADING ' ❑ OUNDATION �STRUCTURAL � `IDE VARD � - - � - _ ,- , � LICENSED CONTRACTOR DECLARATION� ' ' � 1 EF . ❑ TENANT ELECTRICAL ❑PLUMBING .❑MECHANIC 9IDE VA - - � � - � � 1 hereby a(fl�m that I am lic¢�setl untler provlslons of Chartei 9(<om- � ,�. . � .RIGHT � mBnNng With xCtlOn 7000) of DiVision -3, Of the Bu51ne55 'antl � � OTHER � ... _ H'otesSlons Cotle, an0 my IicenSe is in tull fofce antl ef(ett. � � REAR VARD (TO P/y - � '- PROJECT DESCRIP.TION UCen58Cla5i ' LitenSeNo. � , - ' �� � �� PKG.SPACEREQ: �"' ' ' PROVIDED' '- ' Date - � Si9nature - ' . SQ. FT. � . . _ " " , " - - . . _. . . .. _ WORKERS' COMPENSATIOq DECLARATION ", OCCUPANCV � UCTION TVPE STREET WIDTH " PARK FEE $��' 1 h¢r<by a/firm thdt I have a certiTiCdte Of consent to SGINnsure or a � ' ' ZONING APPROVED BV ' DATE �� certitltate-of' Wofker5' Comipenution Insuranca, oy a CerUfletl CODY VALUATION�ZONE - -- thereoN(�Sectlon 3800, Lab. C,�mpanY �i //„n�Q� GRADING CV. VDS. ACRES SPECIAG CONDITIONSi ' - ' /H�� 35�!/i� rtifletl topy Is hareby fUrniShetl. � . .. . REMARKS: �rtlfletl coPY I5 (Iletl witq the titY Builtlin9 Divlslon. � ` � ^'�� - " �. .. • . . . . _ � . EXEMPTION FROM �WORKERS' COMPENSAT N DECCARATION � � V fl' (Th15 5¢ctlOn neetl not ba <UmAletEtl if tha pe t Is tor ona huntl�etl . `� ��� '�' ��, ISLOO� Of �CSS�. � . . . .; ..,.. .. i , '. .. ' '� " ' ' - ' : I. cert fy thdt 0 thB perto�mance ob t w � f yihic this permlt Is - � - i ss�n,adi i�nr n eisP�compensetioo •�o nner as o be e.,PWMBING . "' '- PLAN CHECK ' ELECTRICAL '- -" ' PLAN CHECK". � Date � � �^ Stgnatur ' BATHTVBS 'SHOWERS -' " "' ' � t NOTICE: If after making this tleclaration, you shoultl betome subject .TOILETS . URINALS ' ' • , GENERATOR- �- � p_3 KW_1-10'KW ' ��� ��y ,. : _. .. _ . _ to the Workere' Compen5ati0n pvovisions of the ta�or Cotle, you must - � � �TRANSFORMER � . fOrihwith Comply with SUCh p�ovisions or thi5 permit Shall be tleem¢tl �.°.VATORIES DOUBLE AV$ • APPLIANCE' 10•50 KW_SO+KW'� - - .. . _. .. . .. . �evoketl. - . ' CONSTRUCTION LENDIN6 AGENCV � ' KIT. SINKS ' � " DIS SHERS"- � ��MOTORS OQ HP_1d0 HP ' ' _ I hereby at(irm lhat there is a construc[ion lentling agency for the per- SERV ICE SINKS . SV �- • QNC..SOLAR) 30-50 HP 50 + f{p. - . - � formance oi the work for, Which this Oermit iz issuetl (Secbon 3097 " - r Civ. C.): - . . . ' , - ' ' � FLOOR�SINKS ' � FLOOR DRAINS FIXTURES " OUTCETS"' SWITCHES LenCer's Name - , . . � � • _ .. . : . .. �. Lentler'S Atltlress � � � � i � � { , L ' ' GAS TUBE SIGNS • - ��� �-� OWNER BUILDER DECLARATION ' INTERCEPTORS CLARIFIER ' "i POI_E LIGHTS '� - ' - '"' i I he�eGy af(irm [hat I am ezempt TromS�e Conlractor'S Licenie Law for � theAollowfng reason (Sect7on 7031,5,Business.antl R'ofessions Cotle:. SWiMMING POOL � ' - PTRAP' " ' " � - ? Any cily or county wh¢h requires a permit to construct, al[er, �POLES ME7ERED �SUB ' i improva, tlemolish or repair enystructure, Orior to its issuante, also re-- yyqTER SERVICE '--" ALTERATION PANEL4'• ' MAIN SVB ''- "i quires lhe appliwnt for such permit to file a signetl statement that ha . i5.licensetl pu�suant to the OroWsions ot the Contractor'S Litebse Law � GAS SERV ICE OUTLETS � ' ERV ICE --�- - - ��� � AMP •Q (Chapter �9 (commencing wi[h Section 7000) o( Division 3 of Ihe Busmess.antl R'dessions Coqe)'or that he.is exempt Merefrom antl the yyqTER HEATERS -' BTV OUTPUT ` �� � ''� '" ' ' '" br `or roe allegetl exemption. Any violation of Sectlon 7031.5 by , , a plirant for a permit .subjects the applicant to a civil penalty SEWER CONNEGTIONS ' '" ' -' - ' -- " ' ' " "' ' " - o. more than five huntlretl tlollars ($500). 0 I, as owner of the proparty, or my employees �with wa§es as their SOLAR TANK - "" COLLECTORS � -" -� '"' �"" ''"' sole tompensalion, will tlo the work, antl the structure is nol intentletl .. • -�- . ISSUE FEE '- "-�- ' ' � or o(feretl forsale. (Section 7044', Business antl Profeisions Cotle: The SOLAR PIPING SVS. ' ContractorY License Law tlOes not apply to an owner of a property, qPPLICATION�APPROVE� BV � - DATE A � who builtls or improve5 thereon, antl who tloes such work'himself or � ISSUE FEE ' � �' ' � �`/ 'j/ throu9h hiz own employees, provitletl that such improvem¢n[s are not , ,. . __ , ,_ , - intentletl or offeretl forsale. I(, however, the builtling or improvement MECHANICAL PLAN CHECK SUMMARV OF. FEES . . . . is soltl within One year Of COmpletion, IhC owner will hdve thE burtl¢n �gUILDING ' ot proving he'tlitl nol builtl or improve for the purpoie o( sale). HEATINGSVSTEM 0-100,000BTU � PERMIT E��', SMIP�_ � S �`SO ° � I, as owner of lhe property, am ezclusively contracting with qND DUCTING PERMIT li<enzetl contractors lo construct the prqect (Section 7044, Business 300,000 � BTU PLAN CHECK E ^�- � antl Protessions Cotle:The Contractor'S License Law tloes not apDly to - - - . ISSUANCE .b an owner of property who builtls or improves thereon, an0 who ton- REFRIGERATION 0-300,000 BTU PLUMBING S ' GRADING': S tracts trom such projects �y�th a contractor s) �litesnetl pur5uant to SYSTEM - �� � - the Contractor's UcenSe Law), 100,000 + gTU - PLAN CHECK E ' - , ', � � S_ . ❑�I am exempt u tler Settion & P: C. for this gOILERS BTU � ELEGTRICAL E' =�� - rea5on � � � !' � � L - r PLANCHECK E ' •:.MICROFILM 5-�- oate -�� �� L O E �! /C _.G��I W� SVSTEM REPAIR. ALTERATION TOTAL FEE E MECHANICAL S _ 1 hereby certifythat 1 have A this application antl state that the above EXHAUST SVSTEM MULTIPLE .' LE55'AD- ' informalion is correct. 9ree to compry with all tity antl coun[y PLAN CHECK �S - VANCE PC E ortlinanceSanOs te a r ldtingto ons uction,antlherebyauthorize ' � � .' �• - �� ' ' representatives f h s ' y to er poq [ne above' nli etl property for sp ti r os b� Z , , GINAL FEE E� �� Slgndture ' � Date � � Drivers' License or 55 � � ' � ISSVE PEE - � � - � - - -- � ' • � - - � � � -' CMF 0865-46 Whlle-Builtling; Canary-Appliwnh Pink-Accountin9; GOltlenroA-Asseszor � _ - : :� ,, �:_i,_.: ., , '