HomeMy WebLinkAbout185 18TH ST - Building Permits - Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations. . - T,j-y3 I /29/BE
CITY OF COSTA MES /��`ONSTRUCt�T II-ON PERMIT PERh1V[T (G, TRACT NO. LOT NO. UNIT NO. ' 1I•o2' TL
Project Address �J p 7 y S,/ YY//J!(L�) �,( LI
I
Applicant's Mailing Address TYPE OF CONSTRUCT El NEW u ADD Li ALTERATION LI REPAIR •
996 3ofr: ❑ CONVERSION DEMOLISH ❑ OTHER A p rhe • - Zone
Owner's Name p��M� Phone DESCRIPTION OF WORK/USE OF BLDG. J •
Address' S Main Building: Accessory Building:
\/3 Arch/Eng. License No. TYPE OF PERMIT UGRADING LI FOUNDATION ❑ STRUCTURAL' E Front ZO
Address ' �y 7 ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
.l Contractor's Name Cl---OP Coca co Phon 4/'�- Lae ❑ 'OTHER A -I'
.•'J1 7' Q e,46 ipogNp4 L is. . PROJECT DESCRIPTION SQ. FT: OCCUPAry/p V��.y�••T.��� K Right G
N. Address(mailing) <,� CON STRUCTION TYPE . I VALUATION$ /� WV S Left 1
City License No. 7a 2/ ZONE • GRADING CU.YDS. ACRES R
^ LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed underprovisions of Charter 9,(commencing - Q
( 9 Remarks: Planning Notes: M
V with section 7000) of Division 3 of the Business and Professions Code,and - -
my license is in f 11 force .•tlgff•cl. T
License Class i� eft -License N• 411I 0 •t • S
Date( - -.7 Signature _se„ ._ PLUMBING FEES
Jr-
WO KERS'COMPENSATION DE' LARATION.
I hereby'affirm that I have a certificate of consent to self-insure or a certificate Bar Sink 1 i Showers - ELECTRICAL ,
FEES
Workers' Compensation Insurance; or a certified copy thereof•(Section ,
Io, Lab. C.) [� �-(--' ['..�.�s� Backflow Preventer Service Sink Automatic Washer i Transformer ❑ 15-50 KW:
ronpy No.�{U(G_�G- 7 r?�L,/Company J7 s7✓�• ��a Backflow Irrigation,, :'Sewer Cap _ - - 0 50+KW - • -
,t Construction Pole Sub.
Certified copy is hereby furnished.
Certifl tl Iv Q1�d with the City B d'ng 0 (Sion; Bathtubs ,Sewer Connection , CookingUnit Meter ❑u to 100 amps J-•7 UcalO Applicant I PP .
EXEMPTION FROM WORKERS'COM NSATION DECLARATION Clarifiers-- Solar Collectors - - • Dishwasher _ - Meter Clover 100 amps
(This section need not be completed if the permit Is for one hundred ($100)or - -
less). - Dishwasher Solar Piping Dryers ❑Gas (Electric - Sub Panel -
•
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 ' Drinking Fountains •
- Solar Tank _ - - Fan _ ,
Workers' Compensation Laws of California. - - ' - - - — Motors❑0-1 HP❑l%-.8 '
Date Signature • Floor Drains Swimming Pool w/Spa
'NOTICE:if,after 'making this-declaration, you should become subject to the . • - F.A.U.FAU . -- Inc.Solar ❑9.15 HP 016-15+
Workers' Compensation provisions of the Labor Code, you must forthwith • FIOor Sinks i Urinal
comply with such -provisions or this permit shall be deemed revoked. ' Fixtures , I Microwave ,
CONSTRUCTIONI_LENDING AGENCY Gas Service Outlets, Water Closet -
•
I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light
of the work for which This permit is Issued (Section 3097 Civ. C.) Interceptors 7 Water Heater Outlets '
' Lender's Name _ - - ' Range
Lender's Address - Kitchen Sink - - --- - Water Service - - - Switches - - Sign
OWNER BUILDER DECLARATION
1 hereby affirm thattl•am exempt from the Contractor's License Law for the • Lavatories • Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or ;Standing Sections
I county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays r
any structure, prior to its issuance, also requires the applicant for such permit y Generator 0015 KW❑5-15 KW Trash Compactor
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 Coder or that he/she is exempt _
-herefrom and the basis for the alleged exemption. Any violation of Section ' I • , ,
)31.5 by any applicant for a permit Subjects the applicant to a civil •• _ I •
analty of not more than five hundred dollars ($500). I - - I ,
❑ I, as owner of the' property or my employees with wages as their sole Reinspection Fee , I $15 Issue Fee ' $ 3 •
• compensation, will do the work,and the structure isnot 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 tloes not apply 40 an owner of'a property who builds of improves - -.-__ -_-_ __ —_. - ' ,
thereon, and who does such work himself/herself or-through his or her own • , - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. If, however, the'building or improvement is sold within one year of com- Canopy Type 11 0 - Zoning Approved By , Date
pletlon, the owner win have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date
Prove for the purpose of sale). - - •1 p�p
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - - Application Issued By Date /--d-?'
67
tractors to construct the project (Section 7044,Business and Professions Code: 4
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating - ❑0-100,000 BTU ❑100,000 BTU
builds or improves thereon,and who contracts for such projects with a con- _ . .. SUMIy1�J1 '�,F FEES `__/mss)
, tractor(s) license Pursuant to the Contractor's License Law)..I am aware that Exhaust System 0 Multiple,❑ System Repair/Alteration I }BUILDING PERMIT $ ! r (J SMTP $ /J`�
proof of their Worker's Compensation Insurance should be provided to me. 'PLAN CHECK $ �+ PERMIT
0 I am exempt under Section 0.&P.C.for this reason Firepl/Fact Blt. ICBO#, i I Fire Dampers • .PLUMBING ISSUANCE $
• 5 Ducting - 9 •PLAN CHECK' 25% $ ENERGY P.C. $
Date - Owner Heating ystem)& Re isters - •
'
1 hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,0006TU 1 ELECTRICAL • $ • GRADING $ '
information is correct. I agree to comply with all city and county ordinances and state laws . ng to building cons uction, and hereby authorize repre- MICROFILM S.
sentatives of his c ty to enter upo/the above-mentioned property for - PLAN CHECK 50% $ / �Q�
inspection pu •oses. - / l-n i/ MECHANICAL. $ TOTAL FEE 5' I L t Oma`••)
Signature ,a--or -_. i Date L7�d'V
Drivers' License SS Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK-*25% $
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
•
1 CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector.
1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location . •
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings • 58. Electrical Conduit-Undrgrnd.
8. Foundation l 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 Permit# .
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas IL Oil -
23. Gas Pipe-Rough&Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank I7 Gas ❑Oil i
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 78. FIRE PREV. FINAL
30. Drywall NailingHEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning - '
35. Final Gas Pipe-Test • _ - .
•
36.. Hood or Canopy
37. Final Factory Fireplace - ' .
"
38. Final Plumbing .
I � ' ..
39. Water Service-Final
40. Gas Service-Final ' '
i
'(41-. Solar Domestic-Final ,
•
•
... 42. Backf low Preventer
, 43. Backf low Irrigation ...
-
-44_ Landscape Irrigation System :), , '
..4.5. Sound Attenuation "
. r
46. Handicap Regulations •
- •. - , .
47. FINAL STRUCTURE & BUILDINGI, salt_
q
41L�Qp ��/L /
(48. Special Requirements Completed .
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY A-- ' ,
No. - -- Date -
•
e 0 - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF;;OSTA ME C NSTRUCTI N PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. A.P.# • Zone
//.s A- 390 e-i
Project Address i Ings s 9 °8r r L ` - ft 1 S Main Building: Accessory Building:
Ali�licant•s Mai mg Address `73 3-0,,,,,,...--e) TYPE OF CONSTRUCTION 1J NEW U ADD LI ALTERATION Ll REPAIR E Z
��ff ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' T Front O
Owner's Name J14:9 N.'D/'`Y're Phone S tAti igt DESCRIPTION OF WORK/USE OF BLDG. I B Rear - N
Address 9'7 3 Tu 4/,�P"Q
TYPE OF PERMIT U GRADING Li FOUNDATION LI
STRUCTURAL C Right N
Arch/Eng. License No. K • - G
Address •
❑ TENANT ❑ ELECTRICAL IIIPLUMBING ❑ MECHANICAL S• Left R
I ❑
Phone�(a��,yNOTHER
Contractor's Name - Ping. Ref.# Parking Req./Provided E
� • PROJECT DESCRIPTION SQ. FT. OCCUPANCY - Q
Address(mailing) •--.. i / / Planning Notes: M
����� CONSTRUCTION TYPE ___ VALUATION $ T
City License No. ZONE GRADING CU.YDS. ACRES S
LICENSED CONTRACTOR DECLARATION
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:
Q.., with section 7000) of Division 3 of the Bu ness and Professions Code, and40 -
my license is in full force and effect. ELECTRICAL FEES
License Class -C—/0 License No.J Y,2. ] uR
Date-1J"'sC"ff9' Signature tk .-p PLUMBING FEES Automatic Washer Transformer 0 15-50 KW
\ WORKERS'COMPENSATION DECLARATION . Construction Pole Sub. • 0 50+ KW
•
/t(� I hereby affirm that I have a certificate of conse o self-Insure ora certificate
os
Bar Sink Showers
of Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter ❑up to 100 amps
1, Lab. pG},. I Backflow Preventer Service Sink
-y No. frr^'rC_32%;Q 72.rompany h.—. a W .. . %L_. Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps
NI Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel
.gam Cer ified Sp py is filed with the city = '4..4/Division. Bathtubs Sewer Connection
DDate. ie11 Fr? Applicant ♦ Fan
EXEMPTION FROM WORKERS'COMPEN ATIO / CLARATION Clarifiers . Solar Collectors Motors 00.1 HP 011/2-8
(This section need not be completed if the permit &r one hundred($100)or F.A.U. • Inc.Solar ❑9-15 HP 016-15+
less). Dishwasher Solar Piping
•
I certify that in the performance of the work for which this permit is Issued I Fixtures Microwave
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank
Workers' Compensation Laws of California. Device Boxes
Date Signature Floor Drains Swimming Pool w/Spa Pole Light
NOTICE:If,after making this declaration, you should become subject to the . •
Workers' Compensation Provisions of the Labor Code, you must forthwith Floor Sinks Urinal Outlets Range
comply with such provisions or this permit shall be deemed revoked. .
CONSTRUCTION LENDING AGENCYSwitches Sign
Gas Service Outlets Water Closet
herebyaffirmrk that therewhiis a permit lending agencyc for the performance C.e -
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections
Lender's Name '
•
Lender's Address Kitchen Sink Water Service Generato ❑0.15 KW Trash Compactor
OWNER BUILDER DECLARATION �y1
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash 1 v Af.(raryi.,II 7„ JV
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
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 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 Reinspection Fee , $15 Issue Fee i �q
art
therefrom and the basis for the alleged exemption. Any violation of Section
• '1.5 by any applicant for a permit subjects the applicant to a civil
Illy of not more than five hundred dollars($500). Reinspection $ 3
DEVELOPMENT SERVICES REQUIREMENTS: •
Zoning Approved By
1, as owner of the property or my employees with wages as their sole
Fee I $15 Issue Fee
compensation, will do the and the structure is not intended or offered Date
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date
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 Application Issued By0_-- Date 42/2164/
employees, provided that,such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. If, however, the building or improvement Is sold within one year of corn- Canopy Type II 0 SUMMARY OF FEES
p , the owner will have the burden of proving he/she did not build or im- Duct-Under Ground
prove for the purpose of sale). BUILDING PERMIT $ SMIP $
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT
• 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 Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $
builds or improves thereon. and who contracts for such oroiects with a con-
tractor(s)
license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ n ENERGY P.C. $
proof of their Worker's Compensation Insurance should be provided to me.
ELECTRICAL $ . � GRADING $
❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers
PLAN CHECK 50% $ MICROFILM $
Date Owner Heating System& Ducting Registers
Cat2 4.57)
I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BTU MECHANICAL $ TOTAL FEE $
information is correct. agree to comply with all city and county ordinances - PLAN CHECK 25% $
and state laws re tin to building construction, and hereby authorize repre- -
sentatives of t - ci to enter upon the above-mentioned property for
inspection $
Signature Date 6)-6—P-9 $ 3 01 0036"LS7—C�0's635�7 TOT 21 SiO
Drivers' License or SS# R•einspection Fee $15 Issue Fee DATE: 06/26/£9 'iTt1L: 16:36
0865-46,rev.5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
v--L, 'l
CONSTRUCTION AND PLANNING '
POOL ' 'A
APPROVALS Permit# Jat� Inspector APPROVALS Permit Date Inspector
•
•1. Temporary Electrical Service or Pole r .I 52. Pool & Equipment Location .,
M
2. Soil Pipe-Undrgrnd. •,� 53. Steel Reinforcement
3.,Elec$ical Condit Utility-Undrgrnd. ` •' 54. Forms -- C a
•
• 4. Electrical Conduit-Undrgrnd. ' .f 55. Electrical Bonding
5. Steel.Reinforceme � ^=
nt -,e( 56. Rough Plumbing & Pressure Test .V
6. Electrical UFER Grhd. -7 57. APPROVAL TO COVER-GUNITE
• 7: Footings se 58. Electrical Conduit-Undrgrnd. y
Et:"Foundation ,. 'y 59. Gas Pipe, 0 Undrgrnd.,Test -
ri
• .9.1 Water Pipe-Undrgrnd, l,. / - 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10...-Structural Floor System 2 r r7 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12.'Sewer Cap a 't '
63. Heater & Vent-Final ,
• 13. Roof Drains r 4 '
i 64. Plumbing System - Final
14. Rough Plumbing, 65. Electrical-Final
Y
15. Rough Electrical-Conduit 66. Solar System-Final
�6. 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
X79. 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 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 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. OOD CERTIFICATE ISSUED
33. Final Electric 4/444 / tes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace n
38. Final Plumbing y
39. Water Service-Final _
40. Gas Service-Final 7
41. Solar Domestic-Final .!
42. Backflow Preventer I'1 ,j Lk
•
43. Backflow Irrigation "-}' I4
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations.-
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
I
49. Electric Release to Edison
A1r
50. Gas Release to Southern California Gas Co .j
51. CERTIFICATE OF OCCUPANCY r: - .v
No. Date
t f• 1