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Home My WebLink About193 18TH ST - Building PermitsPtC°STAMESA Applicant to fill in all spaces except those within heavy border lines-and sign an appropriate declarations. - CONSTjRUCTION PERMIT ( PERMIT N0. TRACT NO. LOT NO. • UNIT NO. i - Address IY3 e / (STN . ! -Ksaasy� ft I8390 I /29/86ant's Mailing Address TYPE OF CONSTRUCTIO LI NEW U ADD L.l ALTERATION U REPAIR c.,-oar' TL 's Name y �p ❑ CONVERSIONDEMOLISH ❑ OTHER _ q•p•.* - Zpne �A �HLNLA Phone g`/ 63p•• DESCRIPTION OF ORK/USE OF BLDG. 06M� s��•s _ _ S Main Building: -Accessory Building: E - Z ng. License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION U.STRUCTURAL TFront . - ' Oss - 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL , B OTHER Rear • - - N Contractor's Name �l 1 �i 7 �� - - ' Address lmailingl—!'_S00 �',!q�FOQ WI 14 .y PRO❑JECT DESCRIPTION SQ. FT. oCCUPA CY�{�s CK Right N 7/J q / CONSTRUCTION TYPE VALUATION$ �OSN b. $ Lafb • G City License No. r N f ZONE - GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION . - _ Ping. Ref.# Parking Req./Provided •- E 1 hereby.affirm that/I am licensed under provisions of Charter 9(commencing Remarks: • - Planning Notes: _ M with section 7000) of Division 3 of the Business and Professions Code, and _ ' ' - ' my license is in f II 1 rce and,effecL w•� p��/ , T • License Class• • License Ny.J/`k?R [ O •- - S Date_f--.24eas- Signature -.)'1 .(/ ` 1 • r PLUMBING FEES 1..%\s' WORKERS'COMPENSATION DEC RATION Bat Sink Showers lereby affirm that I have a certificate of consent to self-insure or a certificate • ELECTRICAL FEES Workers''Compensation"Insurance, or a-certified copy thereof-(Section Backflow Preventer Service Sink • J800, Lab. F) -f • Automatic Washer Transformer 0 15-50 KW Policy No.' y0&`f- �'l .�/company�/ 'r� ��D Backflow Irrigation Sewer Cap fa 1 Construction Pole Sub. ❑ 50+KW ' Certified copy is hereby furnished. " ' Certified cop s filed with the city B g Diyis ' , Bathtubs Sewer Connection - • , Cooking Unit Meter nip to 100Fainps ' ate ,- - Applicant - - EXE4NPTIION FROM WORKERS'CO NSATION DECLARATION - Clarifiers - - - Solar Collectors Dishwasher • - Meter -Dover 100 amps - (Thissection need not be completed if the permit is for one hundred($100) or _ - ' less). Dishwasher - Solar Piping Dryers ❑Gas, ❑Electric Sub Panel, I certlfy.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 I Solar Tank , ' / Fan ' I 'Motors❑0.1 HP ❑r.%-8 1 Workers' Compensation Laws of California. , - `_ _ Date Signature a Floor Drains Swimming Pool w/Spa I • F.A.U. - 'NOTICE:If,after making this declaration,you should become subject to the _ . - _ - - _ ._ -_- Inc.Solar 08-15 HP 016.15+ I Workers', Compensation provisions of the Labor Code, you must forthwith Flo&f Sinks Urinal Fixtures ' • comply with such provisions or this permit shall be deemed revoked. -- Microwave CONSTRUCTION LENDING AGENCY- - - Gas Service Outlets Water Closet' Device Boxes I hereby affirm that there is a,construction lending agency for the performance . I - , Pole-Light of the work for which' this permit its Issued (Section' 3097. Civ. 'C.) . . - ' - • - - , Interceptors. • . - Water Heater _ Outlets •Range Lender's Name ' - - ' Lender's Address - - Kitchen Sirik, •-• Water Service ' Switches' Sign ,• OWNER BUILDER DECLARATION - - 1 - - - I hereby affirm that I am-exempt from She Contractor's License Law for the Lavatories'. _ Auto-Wash Garbo a Disposal following reason (Section 7031.5 Business and Professional Code: Any city or - - - 9 p ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair • P-Trap -. - 'any structure, prior to its issuance, also requires the applicant for such permit - , _ Laundry Trays , Generator ❑0.5 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 , , •islon 3 of the Business and Professions Code)-or that he/she is exempt • - _ _ • - ., ( - , -efrom 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 ' - • - ' penalty of not more than five hundred dollars($500). . _ , . , , 0 1, as owner of the property or my employees witti wages as their sole , Reinspection Fee I •I $15 • Issue Fee $ 3 • •compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee ,, $15 •Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - .MECHANICAL - FEES - -- -- - - .. - ' License Law does not apply to an owner of a property who builds or improves ' ' thereon, and who.does such work'himself/herself or through his or her own - • DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not,intended or offered for Boiler - Hood or Type I 0 ' .. sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 - Zoning Approved By Date Diction, the owner will 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). / .yJ� 0 I. as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ' - Date /-�7vY 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- - - - ' - -.❑0.100,000 BTU- 0100,000 BTU - ' • - SU AR FEES builds or improves thereon,and who contracts for such projects 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 BUILDING PERMIT $ !- SMTP $ ' f Sl+ proof of their Worker's Compensation insurance should be provided to,me.. - it PLAN CHECK , $ PERMIT P ❑ 1 am exempt under Section B.& F.C.for this reason t Firepl/Fact.BIt. ICBO,# . Fire Dampers . PLUMBING $ ' S-� ISSUANCE $ Dateowner, ' - _ , I Heating System& Ducting Registers PLAN CHECK 25% $ - ENERGY P.C. I $ I hereby certify that I have read this application and state that the above ❑0.100,000 BTU ❑100,000BTL1 I • GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL . , $ - • and-state laws rel. 'ng to buil•'nq ••nstruction, and hereby authorize repro- i - - 1 PLAN CHECK 50% $ MICROFILM $ inspection sentatives of th'. to e•/r on the above-mentioned 'property for I I inspection r•• / —L% 6 I I MECHANICAL ' $ TOTAL FEE $ Signature I/� Date ^ Drivers' cense or SS# Reinspection Fee : 1 $15 Issue Fee $ 3 PLAN CHECK 25% $ v CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor J.1- ______________________________ N AND PLANNING ; ' y • POO' 'PA . /PROS../ALS Permit # Date Inspector APPROVALS Permit# - Date Inspector • r 1. Temporary Electrical Service or Pole ; -' 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. -1_. r •: 53. Steel Reinforcement 3. Electrical Conduit"Utilii'y-Undrgrnd. - ' 54. Forms 4..ElectriCal ConduitUndrgrnd. 55. Electrical Bonding 5: Steel Reinforceme(tt 56. Rough Plumbing & Pressure Test ' 6. .Electrical UFER �rnd,•-� ., ' ' 57. APPROVAL TO COVER-GUNITE 7. otin s Fo i 9 v ' 58. Electrical Conduit-Undrgrnd. 8. Foundation . ,1 59. Gas Pipe, 0 Undrgrnd.,Test • 9.1Water Pipe-Undrgrnd. f` 60. Backwash Lines, P-Trap, O Undrgrnd. •10. Structural Floor System '•� ., 61. APPROVAL TO DECK 11. Property Sewer Line.& House Connection 62. Backwash & Receptor-Final 12. Sewerv,Cap � 3f.( , � 63. Heater & Vent-Final • 13. Roof,Drains64. 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 7.1. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test , 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil • 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. FrameandFlashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL • 30. Drywall'Nailing I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat •• 79. FINAL INSPECTION • 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound 'Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 10-6.$t L.03 48. Special Requirements Completed • 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, Date • I) Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO -TRACT NO. I LOT NO. ' BLDG.NO. + . - - - - - - - .CONSTRUCTION PERMIT 1 02.. � 2_ ' 1 "' ' Project Address -� r' 303 3/09/82 III ].93'-f F. 1BtFl: _COStd Mesa TYPE OF CONSTRUCTION , . _ ._ ._. _ .. i8.OO I - Owner Rnl'7 Ar Housing Corp. Phone 7g_]450 ❑ NEW O,ADD ❑ ALTERATION - I mss- Q - I - • • �, - - • - I Address 1691 Kettering St. ;--Ir cine 92]1'4- - -O REPAIR 0 CONVERSION-0 DEMOLISH �/v ZONING REGULATIONS' Arch/Eng. - - - - License No. '0 OTHER - - A P • 1 . + DESCRIPTION OF WORK - :Address_ ._ _ _ __ _ _ -- -- - ZONE P $ - •.. • LNG.'REF Contractor -We"---- . - "-' — Phone '� • -' - . - - BUILDING - - - - To g IL DING TYPE,OF PERMIT, PROPUE f2 if _ . . --, . -: •- -- SETBACK GL ST. V LINE 0 GRADING:g 0-FOUNDATION—CI CI STRUCTURAL •SIDE YARD • 'LICENSED-CONTRACTOR-DEd under tDN - -- --- - - ❑ TENANT ELECTRICAL 'OPLUMBING OMECHANICAL LEFT l hereby affirm that I am licensed under provisions of Charter 9 (com- • RIDE YARD" _ • mencing -with'Section-7000)- 0f ('Division- 3 of the- Business-and- O.OTHER --- - - RIGHT Professions Code, and my license is in full force and effect,• I REAR YARD(TO P/L) . PROJECT DESCRIPTION' _ License Class License No. - -L rO'FT : r PKG.SPACE REQ. ,PROVIDED + 'Gate ._ _ dr Signature _ _r .. _ __ _ . _ _ _ .. WORKERS'COMPENSATION'DECLARATION _ . _ _ OCCUPANCY_CONSTRUCTION TYPE ; STREET WIDTH• PARK FEE S. II hereby affirm that I have a certificate of consent to self-Insure,or a VALUATION • • ZONE - "ZONING APPROVED-BY • , ,I DATE „ - certificate of Workers•-Compensation Insurance, or a certified''-copy -thereof (Section 3800, Lab. C.). L _ . ,GRADING-CU..YDS. ACRES -SPECIAL CONDITIONS: , • I „ , icy No. Company - - - - - '" •'ertl(loo copy Is hereby furnished. .- __ --. + '.REMARKS. 4' - - - 7•- - ' - - - - I �•,' ertl(led copy is tiled with the city Building Division. - I' , EXEMPTION FROM WORKERS' COMPENSATION-DECLARATION ' - . • i-- _I - -•- _ - - - ' - - - (This section need_not be completed if the permit isfor one-hundred - - __ -_ _ - _ - _ - _ _ _ _ _ _ __ '_'_' (5100) or less). + Ir - - - I_certify_that n the performance-ol.the work for which this permit is _ - _ _ - issued, I shall not employ any person in any manner so as to become , PLUMBING •, � :PLAN CHECK • ELECTRICAL - PLAN CHECK r, subject to the Workers'Compensation Laws of,Calif or Ma: _ _. UWLLLINO -VAHAOt -- - - - - -, BATHTUBS SHOWERS Date Signature ' 50 FT 50 FT NOTICE: If after making this declaration, you should become"subject ,T,OILETS , • 1:URINALS - ' t- - -' ;GENERATOR • 0-1-kw - i:io KW •' -i to the Workers' Compensation provisions of the Labor Code,you must - 'TRANSFORMER - - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS • - - - - "APPLIANCE 10=50 KW '+-50 KW - _- - - .- ---- - -KIT.SINKS DISHWASHERS - —'MOTORS -" -- ;CONSTRUCTION LENDING AGENCY I 0-1 HP -( I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS . - ' SUMPS— - —. -"` 1(INC.SOLAR)- -10.50'HP_50 +HP ' - - I - - I formance of the work for which this permit Is issued (Sec_tion 3097 - I Lender'sCiv. '- - • s " FLOOR SINKS ' - FLOOR DRAINS - -FIXTURES OUTLETS SWITCHES - Name _ __ - - - - _ _ • •Lender's Address • DRINKING FOUNTAINS I - - ;GAS TU BE'SIGNS- -' -- ' - - - - - - OWNER BUILDER DECLARATION C •• INTERCEPTORS LARIFIERS I hereby affirm that I am exempt from the Contractor's License Law for ) ._ , ' the following reason (Section 7031.5-Business and Professions Code:- -SWIMMING POOL-- PTRAP - -' -' --- •- - -.LuINSIMU -I w10 ---- __ _ _ - _-- _ - -- _ .Any city or county which requires a permit to construct, alter, I 'POLES METERED SUB - quiresve,demolish t for air any permistructure, prior to Its issuance,talso're= WATER SERVICE ALTERATION - :PANELS -MAIN SUB — quires the api.licant for such permit to file a signed statement that he ,.7 is'(Chapter pursuant-to-the with of theContractor'sof Di is License Law - -- - - -_ _. .I GAS SERVICE OUTLETS SERVICE' AMP"-• Chapter n9 (commencing with Section 7000)s eof Division 3 of the - ' usln for t tl- llegedio n5 Cote orthat he exempt o7031,5 and the WgTER HEATERS BTU OUTPUT cc e' for can alleged a permt-sub Anytviolationpof Sectiontby ./19'1,0 . . . . .t_ a• ip l loan[ for a e hundred s the applicant to a-civil penalty -SEWER CONNECTIONS ' ' - - - - - - "-" - -- "' -'- -- -"' • o more than the dollarsmure, prioTS with wages as their- SOLAR TANK 'COLLECTORS -- • -- ' f - . "- -"'- - _ -' -- -_: - - - sole f sat ale..will tio_the work, and the structure isnot intended. __ _ or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. - ISSUE FEE - - - - _ '� ,� Contractor's License. Law dreS not apply to an owner of a property _ _ _ __ _ - -" who builds or Improves thereon, and who does such work himself or ISSUE FEE -I • 'APPLICATION APPROVED BYthrough_his,own-employees, pfovided that such Improvemee,not - - intended or offered for sale. It, however, the building or improvement 'MECHANICAL PLAN CHECK Is sold within one year of completlon,.the owner will have the burden_ • SUMMARY OF.IFEES •r ' ,,,,r of proving he did not build or improve for the purpose of. sale). - BVIL-DIIyG' -' - - -- - - - O-Ip-as-owner of the property, am exclusively-contractingHEATING SYSTEM 0-100,000 BTU _- - PERMIT.y $ - , SMTP _. E ' 4. usw•ith- _AND DUCTING ] licensed contractors to construct the project (Section 7044, Business .\ _,100,000+BTU 'PLAN CHECK $ PERMIT.' - and Professions ode: The Contractor's License Law does not apolyto , .PLUMBING an owner of property who builds or improves thereon, and who con-' -.REFRIERATIOIJ --0-1 ,000 BTU PLUM GING $ tracts-from such-projects with-a-contractor(s) licesned -pursuant to- SYSTEMM - - • -- ' - - - -I•--- -- - -i- - - GRADING $ - - the Contractor's License Law). 1004)00 F BTU P 1 R E ) PLAN CHECK $ p _ , • .• •,1 , ❑ I am ezemPt unBei Section •8.& P.C.for chit BOILERS BTU L 1t dP 11tSC/C. 1ELE•CTRICAL S CS � $- a reason - - - - -- -- '-- '- -' --' ('f; E -- _ _MICROFILM $ SYSTEM REPAIR,ALTERATION t11LV PLAN CHECK bate Owner_ - - - - - I _ _ _ �- TOTA L.FEE$ I hereby certifythat I have read this application and state that the.above_ - S€ _MEC FIANICAL ;E - - LESS AD- ___ EXHAUST SYSTEM MULTIPLE t I information is correct. i agree to comply with all city and County PLAN'CHECK --E - -` VANCE PC E_ ' reprej noes and state laws relating to construction,and hereby authorize nate I • i (epee Property ft city_to enter "upon the above mentioned- ,0:0 - ro ert for Insp purposes. p f i I (,[� -FINAL FEE $ ,rry, 5 at re vrf /' P+ Date Z ' 0 _ i Driv rs' • • of S -; / - - ISSUE FEE - -- - - ' ' - - -- - - - - - - - CMF 0865-46 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor a CONSTRUCTION AND PLANNING '` + lit POOL& SPA APPROVALS Permit# Date Inspector APPROVALS. Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . . - - --- _ 2. Soil Pipe-Undrgrn ' ' . . 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn - 45. Forms •_- - 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding - - - _ 5. Steel Reinforce• 47. Rough Plumbing& Pressure Test 6. Electrical UFER Grn - - 48. APPROVAL TO COVER-GUNITE - .. . - . ! 7. Footings ' 49. Electrical Conduit-Undrgrn • .- I! 8. Foundation '._ - - 50. .Gas Pipe, 0 Undrgrn,Test • ' 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap, 0 Undrgrn • . 10. Structural Floor System 52. APPROVAL TO DECK - - - ' 11. Property Sewer Line & House Connection - - _ - 53. Backwash & Receptor-Final• •- - • 12. Street Sewer Connection _ - ': `_ . . - 54. Heater &Vent-Final ' 13. Rough Plumbing - - -' ' ° . _55 Plumbing S' stem - Final - 14. Rough Electric-Conduit -- -- -'56. Electrical-Final . . . 15. Rough Electric:Wiring - '-- - - - - 57.-- Solar System-Final • ' - - - ' - 16.- Rough Heating & Air Conditioning - - _ _ 58. Fencing & Access Approval _ • 17. Ducts,in Structure 59. APPROVED FOR PLASTERING - 18. Ducts, Ventilating . . _ _ - __ _ 19. Gas Pipe-Rough &Test •• _ _ ._ '- • 60. POOL/SPA.SYSTEMS FINAL - - 20. Roof Framing • - . _. '. t --• - •� • 21. Roof Sheathing ' -` - - - . _ _ _ 22. Frame and-Flashing NOTES: . . , 23. Insulation . tlr;a .�ay / �t�4.4.-1_ _ 24. Lathing &Siding �!. /- -/ .. - . 25. Drywall Nailing _ i _ . - _ • . , 26. Plaster Brown Coat - . . _ •� ._ - - - . _ 27: Electrical Power Meter-Final - _ . • ' 28. Final Electric - _ - . . . - ' • - 29. Final Heating &Air Conditioning_ - - ' .. . . - - -' • - - •_ " 30. Final Gas Pipe-Test . -. - - . - _ 31. Final Plumbing _ - - - - - rt . 32. -Water Service-Final - - . F ? •' e ' 33. Gas Service-Final ' t • - ' ' 34. Solar Domestic-Final E X . FR C B, . ffry9ftfe Inapettiona • 35. Landscape Sprinkling System _ ' 36. Sound Attenuation • _ ' __ __ ' • ' / 37. Handicap Regulations - Date t 7__ / 'gt�4,__ - .' 38. FINAL STRUCTURE & BUILDING - _ - - - , 1 39. Special Requirements Completed - - y ' 40. Electric Release to Edison • ' - - - j _ - - - • 41. Gas Release to Southern California Gas Co: - • - - • _ - • , 42. CERTIFICATE OF OCCUPANCY • ' No - ' Date • - - '• - . . . . _ _j - . . _ .. _ _. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. , CITV'OFaCOSTA MESA CONSTRUCTION PERMIT PERM NO. TRACT NO. • LOT NO. UNIT NO. - B394 1/29/3S I ,:o.. Project Address _/2( 3 / J. e /g7w ,sl acid 4/7 1 • ' Applicant's Mailing A�7ddres .A TYPE OF CONSTRUCT U NEW 0 ADD U ALTERATION U REPAIR Owners Name 1.4 els.,‘ LIRA — PhonecYl' ❑ CONVERSION DEMOLISH 0 OTHER A.P.# Zone 3�d,1 DESCRIPTION OF WORK/USE OF BLDG. DEMO SF/?. _ Address - - S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT 0 GRADING 0 FOUNDATION U STRUCTURAL T Front . 0 Address - q �/� ❑ TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL ' B Rear • N Contractor's Name' Tq�H� no 0 0 Phon t.3c SO ❑ 'OTHER A C Right __ N C\�1(^�\' Address(mailing) jjf 304 C'�9�-/fo?�� La 01.4 f4tjfgi. PROJECT DESCRIPTION SQ. FT. - OCCUPANCY/ by K _ G g Qp1 f • CONSTRUCTION TYPE ' VALUATIONS Js q/D B Left • ' City License No, �Q ZONE • GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E \ I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - , Planning Notes: • , IOvI 1 with section 7000) of Division 3 of the Business and Professions Code, and • - T my license is in fyIt fo�enq effect. /se kf d S DLicense Class_,. / ign /Elk o./ - C Date_ _42.1. .12- Signature PLUMBING FEES \ WORKERS' COMPENSATION DEC RATION Bar Sink , Showers I ELECTRICAL FEES 1 hereby affirm that I hive a certificate of consent to self-insure or a certificate - f Workers' Compensation Insure e, or a certified copy thereof (Section Backflow Preventer Service Sink Boo, Lab. C.) _r Automatic Washer Transformer 0 15-50 KW • Policy No.NYS S yy Company STH'TF PC'," • Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+ KW Certified copy is hereby furnished. Certified cyo�,p� s jjiletl with the city B e Di a12., / Bathtubs Sewer Connection ` Cooking Unit Meter ❑up to 100 amps Da a/a--; l" - 6 • Applicant ,��.. . /DEC _ _ _. EXE rvIPTION F OM WORKERS'CO �- NSATION DECLARATION Clarifiers , - Solar Collectors — Dishwasher - Meter Dover 100 amps (This section need not be completed if the permit is for one hundred($]00)or - a - less). ' Dishwasher . , Solar Piping l 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 soas to become subject to the Drinking Fountains Solar Tank , Fan - Workers' Compensation'Laws of California. - - Motors 00-1 HP 0114.B Date - Signature Floor Drains Swimming Pool w/Spa. F.A.U. ' 'NOTICE:If,after making this declaration,you should become subject to the • Inc.Solar 09.15 HP❑16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal _ ,_ Fixtures Microwave comply 'with such provisions or-this permit shall -be deemed revoked: _ CONSTRUCTION LENDING AGENCY • - Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which' this permit is issued (Section- 3097 Civ. CJ Interceptors Water Heater Outlets Range Landers Name _ Lender's Address - - Kitchen Sink • Water Service - Switches. , Sign OWNER BUILDER DECLARATION : ' - - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - Garbage P Disposal following reason (Section 7031.5 Business and Professional Code: Any city or - ;Standing Sections , county which requires a permit to construct,alter,improve,demolish or.repair, P Trap Laundry Trays, - Generator ❑0-5 KW ❑5-15 KW ' ''any structure, prior to its-issuance, also requires the applicant for SuCh permit ' - - Trash DOmpeGiOr 'to file a signed statement that he/she is licensed pursuant to the provisions of • -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 , _ - . - - vvy l,_ pfrom and the basis for the alleged exemption. Any violation of Section ` ..„.5 by any applicant for a permit subjects the applicant to 'a civil ' - s ?Ally of not more than five hundred dollars($500). LJ 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 is not intended or offered Reinspection Fee , $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - - - MECHANICAL FEES - - • License law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or'her ownDEVELOPMENT 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 II 0 Zoning Approved By - Date oration, the owner will,have the burden of proving he/she did not build or irn- Duct- Under Ground • Building Approved By Date rove for the purpose of sale). • • �/3 ) o I, as.owner of the property, am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System _ Application Issued.By Date /_r'7 ii4 tractors to construct the protect (Section 7044,Business and Professions Code: ' The Contractor's License Law does not apply to an owner of property who ' Duct-Ventilating ❑0-100,000'BTU 0100;000 BTU ' builds or improves thereon, and who contracts for such projects with a con- SUMMAR�QF FEES tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT ' $ 1-7...,s Li SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT I i ❑lam exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO 4 Fire Dampers PLUMBING $ ISSUANCE $ • Date _ Owner ' Heating System&Ducting Registers PLAN CHECK 25% $ ' ENERGY P.C. $ I hereby certify that I have read this application and state that the above ; 00-100,000 BTU 0100,000BTL , ELECTRICAL $ GRADING $ information is c. • t. I agree to iply with all city and county ordinances , and state law elatg to uildl nstruction,and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ sentalives o this. Ityl`[ t on the above-mentioned property 4f2; inspection` po • �� MECHANICAL $ TOTAL FEE - $ i(�t+•"Oa ,/ Signatur• Date . , - - - -- - - CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING '+ POOL '°A APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector `t. Temporary Electrical Service or Pole ; -1 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • • 3. Electrical Conduit_Utility-Undrgrnd.' 54. Forms ' 4.'.Electrical Conduit-Undrgrnd. • 55. Electrical Bonding 5. Steel'Reinforcement : - . 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. • `'. 57. APPROVAL TO COVER-GUNITE 7. Footings 58• . Electrical Conduit-Undrgrnd. rt 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 Coniieltion - ; - 62. Backwash & Receptor-Final 12. Sewer,Cap i I 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. RougklPlumbing - 65. Electrical-Final r • - 15. RouglrElectrical-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 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. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace • 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 5 41. Solar Domestic-Final P 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 117fro • 47. FINAL STRUCTURE & BUILDING 014.-48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date •1