HomeMy WebLinkAbout396 18TH ST - Building PermitsPNOJECT RDOBESS: 3 y 6 E 1 8 TH $T �N�T� I
OWNEfl'SNAME: SUZANNE GILDRED � �
noonEss: 616 ST. JAMES RD
NEWPORT HEACH
CA 92663
�PflCHIENGINEEfl:- TOM L�V� xec.xo.: NONE
aooncss: 2033 LAURIE LN uxir:
COSTA M$SA CA 92627
` PEflMITTEE: SUZANNE GILDRED ( 714 ) 646-9286
PDOXESS: E11G S'J'. JAMES RD '
NEWPORT BEACH CA 92663
LICENSEO CONTflACTOfl OECIANpTION: I �ereDy affirm �ha� I am licensea wder pmvisions of Chapter 9(commencing wiih Section
7000) of Div�sion 3 0l t�e Business antl Prbiessions Code, antl my license is in tull brce and eifect.
GTY UC.: STqTE LIC,; C1A55:
Date: SignaWre:
WONREPS'COMPENSATION OECIAflFTION: I here0y a��irm Ihat I have a cenitica�e of consen� to sel4insure or a certificate of Workers'
Compensation Insurance, or a certitied copy I�ereol (Sec�ion 3800, Lab. C�.
POLICY NU.: E%P. DPTE:
�'COMPANV:
� Cerlitied coDY is here0y lumishetl. ❑ CehifieC copy is file0 wi�h I�e ciiy Builtling Oivisioa �
Date' AOPlicanL
E%EMPTION FNOM WONNEPS' COMPENSFTION OECLAPpTION: (T�is section neea nat be completetl if ihe permit is tor one hundre0 (St00) ar less�.
' I cetlity that in the pedormance o� Ihe work �or which Ihis permii is issued, I shall no� employ any per5on in any manner so as to become
Subleci lo �he Workeri' Compensation Laws o� Califomia. � y'
Da�e'. Signaiure'. � �
NOTICE: I�. alier making �hi5 detlarali0n. you Shoultl bemme Suble�� �o Ue Workers' ComDensation orovisions ot ihe Labor
Coae. you musl lorthwith comply witp SucA Omvisions or Ihis Oermil shall be tleemetl revoketl.
� CONSTflUCTION LENOING AGENLY: 1 he�¢py a�lirm Ihat there is a ConS�mction IenOing agency �or �he OerfOrmance Of Ihe wOB tor
which Ihis Oermi� is issueQ (Section 3097. Civ. C�.
LENUEP: �
ADOHESS:
OWNEF BUILUEB OECLABpTION: —I herehy aflirm that I am exempt Imm Ihe Contractors' Stale License Law for roe following reason
�Seclion 7�31.5 Business and Pmtessional CoOe: Fny ci�y ot county w�ich requires a permi� Io conSVuct, alier, impmve. demolish, or
repair any siruclure. prior lo its issuance, bisa repuires �he applicani for such permii lo lile a signetl italemen� �hat he/5Ae is liunsetl
pursuam m the pmvisions of Ihe Coniractors' Slaie License Law �C�apter 9 �commencing wi�h Sec�ion 7000) o� OiJision 3 0� Ihe Business
antl Pmiessions Code) or iha� he/she is exempt Iherelmm antl the basis �or the alleged exemption. qny viola�ion o� Seciion 703L5 by
any apPlican� tor a permi� sublects �he apAlicantlo a civil penalry o� noi more �han five huntlred Qollars ($500).
..y( I, as owner al I�e pmperty or my emDloyees with wages as their sole compensalion, will tlo �he wo�k, antl the
1�t s�mc�ure is not in�entletl or afferea lor sale �Sec�ion 7o44, Business antl Pmfessional Code: The Contracbrs' Sta�e License Law
tloes nol apply lo an owner o� a pro0eny who buil�s or impmves ��ereon, and who tloes such work himself/hersel� or �hrough
, his ar her own employees. pmvidQd Ihat such improvement5 are no� in�entled or oifered lor sale. Ii, however lhe buil0ing or
impmvemen� is sold wi�hin one year ol compietion, Ihe owner will have the burden ol pmving he/she Oitl nol buiitl or impmve
for the pur0ose of sale�.
I, zs owner of t�e pmDerty, am exclusively contracting with licensed conirac�ors to consimct ihe pwject (Section 7044, Business
.antl Pm�essions Code: The Contrattors' Sla�e License Law Ooes not apply �o an owner o� pmpe�y who builtls or improves �hereon
and wha coniracls lor sucRD�ole�is with a coniracmr(s)license pursuam ta ihe Contracbrs' State License l .I am aware
�ha� prool oi Iheir WorkeYs Comp¢nsalian insurance shaultl be D�ovitletl �o me. ///
� I am exempl un0er Sectian: B.�&�C � � ' /
for tnis reason� _ /
�a�e: � " �
I do hereby cetldy Iha� I an aware al antl UnaerSiantl �he reQuiremenls o
25534 and Ihal I or any iNure builtling occppant willlwill noi (circle one) r
permit for cons�mclion or motltlication imm �he Air Oualiry Managemeni
,I�ese pmvisions.' �
25505,25533,and
repuiremems br a
is are exempl �rom
Daie: pOPlicanP. �
I here�y cetlity �hal I have reatl Ihis applicntion d sla�e ih �he ahove inlormation is c ec�. 1 Pe to comply v' all q
ordinances an0 statelawsrelatingto buildiny isiNction z ereby authorizere0�esent es oi' s cilyto enter ont�e abc
pmperry tar inspeciion purposes.
1 ♦
�ale:l %. /��_/ �j U., ' Si ur
� i
o�i�er's �tcense or S �iai secu�it� a:
t641-46 W�i�e—Builtling; Green—Gatle Enlorcemenl: Canarv—Applicam: Pink—Revenue: Golaenrotl—Assessor
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: P 050281 PLAN CAECK NO: N
�
CONSTRUCTION TYPE: S—N PERMIT TYPE: PLU
JOB DESCRIPTION ; 91 SQ FT BEDROOM EXPANSION, RE:BE50023
•0-• �• 1 1
e�r � �.. .
•^1 ���
SQ FT:
CLAIM VALUE: CALC—VALUE: , GROUP OCC: R-3 /M-1
COMMENTS; RELOCATE SEWER 6 WATER SERVICES
**��rx�x**�r***�r�t�r*�t�t�r��**�xx�t�rx�*+r*�r*�r*�t�r***x**x��r�e�**�t****�**�t�r�t**�t�t*�r***�t*�+r*****
Z O N I N G R E Q U I R E M E N T S -=-�
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: ' FT SN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL: 11729138 ZNE: REF NQ;
PLANNING Nt57'ES>
i '
ik 3F iF IE 1E if 1E 1ElE iF �If if iF iF if if iE iF if 1F iE �f �E iE IF �F If iE iE if aF IEaf iF IE iE fF iF iE IE if iE * iE )f �F 1f K iF if 3F if If IF 3F 1f lE iF iF iF IE IE k* iE IF iF �E �E 1E iP iF if !E iE iE iF iE 3f
D E V E L O P M.E N T S E R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : ' DATE:
APPLICATION ISSUED BY: � DATE• ��F�����'�j��"
IE1fklFiFiFiFiFiP#f3f�tiFifkififiE3FiFlfltTFiF3F3fifiFiFiFffi�3Fif7i"iFiF'�T£'Tf'iFif if�F7F3F3F7F�f3F3F'iF'�'iFlf3fif3F�fiklFN�iFIh �l�F
iF iF IE iF iF iEiE 3k �t �f if if it 3f if 3E if if iE fE IE 143E jE if �F if k ik �F if� if if if �lE iE iE IF iE 1F 3Ell� 1t iE if ik �IP fF iE iF�F iE �E iE If �E IE �E iE iF ik 1E -1F 1F iE 16 3f if IE iE 3F if 1F # if iE if iF �)f
LEGALIZATION:N F E E S U M M A A.Y STRUCTURAL SEGMENTi13
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT ��SY SMIP/NON—RES
PLAN
ISSUE FEE 3,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7.00 3.00 0.00 50,00 10,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 10.00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP'/TOT GRADING PLAN—CHECK
1 Q . Q �
1k iF ik 1E 1k iE it iE 1F 1F IF il� iE iF iF 3Eif iE iE Ik IE if iE iF iF ib iE i! iE fElF iE iE �E iF 1F if iF IE iE 1E 1E if IE if IE if if 1E 3F if iE iF iF if 1f if iF iE 1F if iF iFif iF if iF iF if 1f �F iF if iE # 1F iE iF if
I N D I V I D U A L F E E B R E A K D O W N
,TYPE
PLU
QTY D E 5 C R I P T I O N
1 WATER SERVICE
,1 SEWER, BUILDING / TRAILER
END OF FEES
UNIT COST
2.00
5.00
TOTAL COST
2.00
5.00
G��
0
01 R007eI33-Ot�07G13a �'�a'i ',10,:�
Up?F' t?,'13/90 TFqE: it1:01
� �
CONST@.IICTION AND PLANNING ' � �'.� PO. y SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
i '�
1. Temporary Electrical Service or Pole � 52. Pooi & Equipment Location ' �
2, $oirPipe•Undrgrnd_ 53. Steel fleinforcement __
3.-Electriwl Conduit Utifity-Undrgmd. 54. Forms � �''' �. �
^- _4. Electrical:ContluiYUndrgrnd. 55. Electrical Bonding • , _ �
"� 5. Steel Resnfor'cement - 56. Rough Plumbing & Pressure Test � -
�.�6.zElectrical UFER Gmd. 57. APPROVAlTO COVER�GUNITE
� •7.'FOotings ' .,�_�. 58. Electrical Conduit�Undrgrnd. �
%� S.:Foundation �.ti 59. Gas Pipe, Q Undrgrnd., Test '
�... .
9. Water Pipe-Undrg�nd. 60. Backwash Lines, P-Trap, � Undrgrnd. Y
10. Structural Floor System 61. APPROVAL TO DECK �
i t. Property Sewer Line & House Connection ��' 62. Backwash & ReceptorPinal� �-'��f__ -�y
12. Sewer Cap , 63. Heaier & Vent-Final . t
13. Roof Drains�:� � 64. Plumbing SYstem - Final �-i, � �'
14. Rough Plumlii_n9 65. Electrical-Final �
f�4
15. Rough Electrical-Conduit 66. Solar System-Final � �
•L
�16. ROugh Electric Wiring 67. Fencing & Access Approval .�}
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING :
18. Rough Electrical-T Bar Ceiling 69. POOI(SPA SYSTEMS FINA�� •
79. Rough Heating & Air Conditionin9 FIRE DEPT. REQUIREMENT �
_ , , ,�. �
20?rfiough Facto.ry F.ireplace �=:•�' �` ° G _ < �APPROVALS' �-� �Permit # � - '
u n v .s. �;i * .t �x: - - -
21.'. Duc4s, in�Str�uctuie, � . ; . . � � � ,70. Underground HYdro � �
22. Ducts, Ventitating, � ?» �'ry ',� '-77, product'Piping O�Gas O'Oil
23.;�Gas Pi e�Rou h & Test � - ' y �• ' '� � � ' -
P 9 r•, >,. t; ( � . 72. Undergroand Flush;� ,
24. Roof Framing � � � , . : i = ^ _ + � �73r UndergmdtStorageTank'�Gas ❑Oil" •
25. Roof Sheathing =,, 5: ti�, � �= - ' �74--Overhead HYdro� � ;
26J�T-Bar Ceiling (Structural) &=Monocoat Y- �u �� :�:+ F 75?Dry Chemical� ' � _ =`�
� r:
27:4Frame and Flashin ` �� ^' ` ` .s;`� ' � ° �
. A , s. �x . ,,. ,, � 76:- Dry Stanc]P!PQ . x
` 28. Lzthing & Siding; � :c = _ i, � • •�i ��>� » 77�;- FIXED SYSTEM EINAL' _
''29. Insulation ��` - �s � � ' ` I '" ' 7g�FIRE PREV.!FINAL `�!' =
�� 30. Dry`�`�all Nailin9 , f � � � �• :r^�� ' �- HEALTH��DEPT% REQUIREMENT
�_ 31. Plaster Brown Coat' � '� � � ' 79 �FIlUAL' IfJSP�ECTION - " `� �
� .
,.
��32.. Electrical Power�Meter�Final� .. ! 80::.F000 CERTIFICATE ISSUED�
.,... -..� .
33.; Firial Electric t � � ` Notes: _�, _ .
;34- Firial Heating'�& Air. Conditioning; ' � � h .. ., ,� :i � ,�: t -
.r
35:"Final Gas Pi'pe-Te'St'� T�I' "7 I • ,r�, ��' � ��:�
� - .x 4 i. ; i� . ".. . _�� .,.
i36. Hood or CanoPY" . - . _ . > ,. y- �
i
37f=Final Factory Fireplace^ • � �' -' " � ` ' - ; ��
� c.- 1
,� 38. Final Plumbing ... � ,t � � -� i • �� �- �• �-
. -39. Water Service-Pinab - - , • - � ' `
;� .
; 40. Gas Service-Final ; �,, ;i,- ,. ' ��: ' _ �;�� .
�41. SolarpomesticFinel�: •� � :.� � � '' _ '
a
•"42. Backflow Prevente� ` � � ' � � �� ' � - `
� 1� a. .
43. Backflow Irrigatiort �"� � ' , � ' � `•"�
c
� " i � . .. 5 �s
;,44. Landscape Icrigation System,y;' , . - - - , . �.� _ .
�45.=Sound Attenuation -'� : � � . • ' _ � `-'. •
r,
?46. �Handicap Regulations - " � � � ',; ;� :l = � .
.i • -
47.�FINALSTRUCTURE&BUI�LDING � .,• ��� - -�
48.'.FINALPLANNING ' ' __. 1 - ---
4
_ 49.sElectric Release to Edison � �i, � >: �.� _
�.50.; Gas,Release.io Sou_them California Gas Co ' I � r- � � - . '" � . � � � ' '
,�
' 51. CERTIFICATEOF:OCCUPANCY :, . . -. �; _ . " �
No Date i
�
1
PPOJECTp00HE5$: 396 �• 18T•H 5+•i• UNIT:
OWNFfl'SNAMF: SU�I.ANNE GILDRED
nooeess: 616 ST. JAMES RD
Y ;,;..idEWPORT BEACH
,�, � CA 92663
�ANCH/ENGINEEq; TOM LOVE flEG.NO.: NU
aooeess: z033 LAURIE LN �'
y PEflMITTFF: COSTA MESA CA 92627
RDOXESS: SU%ANNE GZLDRED ( 719 ) 646-9286
616 ST, JAMES RD
NEWPORT HEACH CA 92663
LICENSEO CONTNqCiOfl �ECLAPATION: I here�y alfirm Iha�l am licensee un0er pmvisions ol Chapter 9 �commencinq wilh Section
7000� ol Orris�on 3 al ��e Business anG Pmleuians Coae. an0 my license is in lull imce ana ellect.
CITY LIt.: S�RTE LIL.: ClASS:
Da1e: SipnaWre:
WOflKEPS' COMPENSRTION OECNflAT1UN: I �ereby affirm ihat I �ave a ceniliwte ol ronsent to sell�insure or a certilica�e ol Workers'
CompenSdtUn Insurance. or a cenifiea toOY �nereol (Seclion 380f1. Lae. C).
POUCY NO.: EXP. ORTE:
comvnxv:
❑ CeN1ie0 copY is �ere0y fumi5�e0. ❑ CenilieE coDY is liletl with t�e city Builtlinp Oivisian.
Oalp: AppliCani:
EXEMPTIUN FpOM WOPY,EflS' COMPENSATION OECLABATION: Qhit Stttion nttG not 6e compleleU il Ille permit is lor one AUMrttl g100) m less�.
I ceniiy inal in ine pedormance of ine work lor wnicn �nis permit is issuea. I sAall not employ any De�san in any manner so as to hecame
su�jecl ta ine Workers' Lompensation Laws ol Calilornia.
Oate: SiqnaWre:
NUTICF:II. aft¢r making I�is Geclaration. you snoul0 become sublect to �he Workers' Compensaiion D�ovisions oi I�e Labor
CoOe. you muEl lon�vnt� eomDN ��� such O�Ovisions or iMs permit 5�all �¢ Eeemea revoketl.
CONSTBUCTION L�NOING RCENLY: I �¢reby aifirm I�a1 there is a construction lenaing agency for IAe Derlormance al IA¢ work lor
w�iU Ihis permi��E issued (Section 3097. Gv. C�.
LENOEq:
FOORESS:
OWNFP BUILOEB OECUB�TION: I �ere6y affirm that I am exempt Irom tAe Comracmrs State License Law br t�e falowinq reason
�Seclion 7031.5 BUSiness anG Pmfesvonal CoEe: Pny city ol county which repuires a permil to cansimct, alter, impmve, demoli50. or
ceoair any simcture, prior to ils issuance. also r¢puires ine a07licanl for sucA Dermii to lile a signetl stalement inat n¢/she is Ifcensea
Dursuam to t�e provipons al the Comracmrs' Sta�e License Law (C�apter 9(wmm¢ncinq with Section 7000) af UNision 3 ot the Busineu
ane Pmlessians CAtlel or ihal he/sne is erempt Inerelmm and tne baiis lor Ihe ailepetl exemption. My violation ol Seclion 7037.5 Dy
any apDlicani lor a permil 5u0jec�5 Ihe applicant lo a civil penalry oi noi more I�an �ive huntlred dollars �5500).
1, as awn@� ol the properly ar my ¢mployees wi�h wages as �heir wl¢ compensation, will tla Ihe work, and the
❑ stmcWre is noi inlenUeU or of�ereE lor sale (5¢tlion 70C4. Business an0 Pro�essional Cotl¢: The ContraC�Ofs' Slale Litense Law
Goes wt appty m an owner of a DmDetlY w� OvilCs ar impmves tAerron, an0 wlp tloes such work himself/herulf o� t�rouph
Ns or her pw� emDloyees, O�witletl Nat such improvemenis are noi intenUed ar atteretl br sale. Ii, however t�e butl�ing or
. impmvemery� is soa vnlhin one year oi campl¢Iion, Ihe owner vnll have I�e �urden ai Oroving he/ihe Ei0 noi Oui10 a� improve
br ihe purppye ol 5dle�.
� I, as owner ol t�e D�oOehy, am eKClusivelY conlractinA "^�� Iicense0 coniractors lo constmct ihe pmlect (Seciion 7044, Business
an0 Rofessiuns CoUe: The Contractors' State Licrnse Law Ooes not aODN �a an ovmer oi pmperry who 6uilOs or improves ihereon
antl who comracts lor such prqects vnt� a contracmqs) license pursuant to ��e Contracrors' S�ate License Law). I am aware
i�ai D�oof 01 tneir Woder's Compensaaon insurance shoul0 �e DmviOea to me.
� I am exemp� wder Setiion: B. 8 P. G �
IOf ItIiS fCdSpp; �
Dare: ( �- .L�_�7 � .
I Eo �erety cendy �pai I am awam of an0 unUeman0l�e repuirement ol Calilor ia H,ill� anA Safety Cotle Sectians 25505, 25533, an0
2553d aM t�at I or any IUWre GuilCinp occupanl vnlVwitl n �(d�Ue on¢) n¢e010 ry with uiA state caaes ana tht reQuirtmems lor a
permil Ior [an5buqion ar mOUiliCdlion Irom Ine Air uahiy Man' ¢meni DiSlrici. FeSidenii on5im �On aDD�iCalion5 m0� ��om
Illese provi5ion5. ,
Oale: _/� ��_[_ AD ican _
I �ertUy t¢tlily ��ai I tuv¢ r¢ad INS appticaiion an 51a1e IAaI a�ave intormation is coirecL I a ree ta c ply wiltl all �iiy an0 COUnry
O�dinaMCS dnd Sidl@ W',v5 �Cldlinpl0 OuilOing LOR5��1%�1On dnG �E�E � U�M�¢¢ �¢p�E52�ldliv¢SOIt � plyl0 1lfUpOn��¢2 t�liOnM
pm0erly lar in50etli0n putpoSes.
Date:_/�.._.�_� /_� Signatu �� _
Dri�er's �icense o� soc�ai sec��ny .: �, �
16<Lab Wbne-9uilding; Gwen-CaEa Enlorcamom; Canary-Applicanl: Pink-Ravanue; 6oldenrotl-Asses9or
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: BE 05002
PERMIT NO: 131i 050023 PLAN CHECK NO: 06812-90 S GOVT: N SUPP: N
CONSTRUCTION 2'YPE: 5-N PERMIT TYPE: ELE STA PURPOSE: ADD
JOB DESCRIFTION ; 41 SQ FT BEDROQM F.XFANSION (ADDZTZON) SQ FT: 91
CLAIM VALUE: 3,000.00 CALC-VALUE: 2,829.00 GROUP OCC: R-3 /M-1
COMMENTS: 5MOK1'i DETECTOR(S) RE�iUIREDIN HOME.
**+riE*�ttitM�xr,:�r��riF3f�r��eififit*�ititiEit *iFiE*?t*itxitiriE+riEit*it�*itif**itit�rkititiFif*it*x*ftit*iE�r�r**it�•x*if
Z O N I N G R E Q U I R E M E N T S
S H T B A C K S
-----------�- MATN BUILDING ---------- --------- A�CESSORY BUIiDZNG ---------
FRNT: 35 FY IN REAR: 13 FT IN FRNT: FT IN REAR: FT IN
LEFT: 29 t�'!' 6 iN RGHT: fiT IN LEFT: FT IN RGHT: FT IN
PAAKING ItliQ • 2 PROV: 2 PARCEL: 11729138 ZNE: R1 REF NO:
PLANfv.[NG N(51'ES> 41 SQ FT BEDROOM EXPANSION TO EX SF RESIDENCE WITH DETACHED
> GARAGE
Ik if jE )f 7F Y C� Y%�1F M �f iE iF 1E 1f if If M�% Ikif IE ib iE �E 1E 1f iE iE if if �f df ik if 3f N� M iM1 if if iF if 1FlE �f if iF if �f !f iE if 1f ff 1f M if �f if jE If if 1f �E iE iE i114 iF �1f� �f 1f?f �f iF+f iF
U E V E L O F M E N T /S E�R V I C E S R E Q U I R E M E N T S
ZONING APPItOVED BY ; %f/ � �Zr-��///�% DATE: / �
BUILD:CNG APPROVED BY : DATE: �y�%
APPLICATIUN ISSUED BY: .-� DATE:
IEifififklFklfi�ik�FifiFK-iEififlf�f#iFiE �ElfifiFifM*�flEif � ifif
�kifiFifiklFifiE�E�kM'1FkiE�ElE3fif�lfMifit�iEiFiflFIf�ElfiEifkiFiEjEif* � klflfiE*1fiFiElEif�EiE4lfiFififiliEiklklk�F�Eifif3fil�f�fifif*iFif�f3Fifif�k
LEGALIZATION:N F E E U M M A R Y STRUCTURAL SEGMENT:Y
13i�OG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERM3T 59.00 3.00 50
SOx SMIP/NON-RES
ISSUE FEE 35.10 '15.00
BUILDING-DIV-> PERMI'f ISSUE PLAN-CHECK TOTAL PASD DUE
TOTALS----> 57.50 15.00 ;"= 35;10 107.60 107.60 .00
REVENUE DIVISION TOTAI.S=-> COLI,ECTED: 107.60 OVER/SHORT; 00
BI�DC Pi�7T PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLRN-CHECR
54.00 18.00 � .50 35.10
if if if 1f iE k if 3f jf iF �F lE 3f iF iE iE if iE k if iE If if�iE 1F 3F 3f iF iP If iF �1f� �F d4 jE af If iE ib if iF �)f 1E 1F 1E N� k ff X� iE IF lE �E 1(�?E iF if if �E aF iF k a4 3E iF IF 1f * 1F 1E iF �lf iF iE it 7F iE �f �f
i N D I V I D U A I. F•E E B R E A K D O W N
TYPE QTY D G S C R I P T Z O_ N UNIT COST TOTAL COST
SFR 41 DWIi-'TYPE V-WOOD FRAME . -GOOD 69.00 2,829.00
iLE 1 FIXTURES LIGHTING 1 ST 20 EA. .75 .7�
ELE ?. RECEFT/OGTL&T �1 S'C ?.0 EA. .75 1.50
ELE 1 I21iC1iPT/SWITCH `S S'P 20 EA. .75 .15
END OF FEES
ez eoc��,���-��r��4,5, _, r_-,�- ,r .�,
DATE'� 17i21.b� I'tHc� u9:51 J
�
-- ------- ,
' � PO� _ d SPA
CONS�RUCTt9N AND PLANNING •
APPROVALS Permit # Date I�spector Date Inspector
APPROVALS Permit #
J
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location l '
� ,
2. Sojt Pipe•Undrgrnd. ' S3. Steel Reinforcement �' ,�•
. ,
3. Electrical Conduit Utility-Undrgmd. � 54. Forms . )' '
.
4. Electrical Conduit=Undrgrnd. � 55. Electrical Bonding - �
5. Steel Reinforcement � 10 �( ,FJ� 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
� 7. f.00tings � � �p � D� 58. Electrical Conduit-Undrgrnd.
8. Foundation � � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Und�9rnd. , 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. Sewer Cap 63. Heater & Vent-Final • •
7 3. Root Drains ' ' � 64. Plumbing System - Final •
14. Rough Plum6ing ' � 65. Electrica6Final . �
15. Rough Electrical-Conduit 66. Solar System-Final ' '
16. ftough Electric Wiring 67. Fencing & Access Approval �
i7. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough Electriwl-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
��• ��nf �;
20. Rough Pactory Pireplace ' � � • • ' �APPROVALS•'� �Permit #
. � . � �_,. . .
21. Ducts, in Structure , . x � . .' 70. UndergrourYd.Hydro �
22. Ducts, VentilaU�9 • •'• 71. Product Piping O`Gas ❑ Oil
23. Gas Pipe-Rough & Test � �+ 7Z, Underground Flu'sh= . -�
24. Roof Framing ' -' -- - 73. Undergrnd�.StorageTank �Gas ❑Oil -
25. Roof.Sheathing . , ' � � . \74, �pverhead Hydro �
26. �T-Bar Ceiling (Structural) & Monocoat � � i ��' � F 75.' Dry Chemical � �
27.'Prame and Flashing. ; � j. .. ' ��, �y ; ; 76. Dry Standpipe - . �
28. Lathing & Siding, � �: � � ��•� �" •� : 77,�'FIXED SYSTEM�FINAL ' '
29. int�lation' - ' • '. � � . ,
� °' 1�'�1 ;,,,�j F 78. FIRE PREV. FINAL
�30. Drywall�Nailing - � � � -+ ' � � �' � � "�� HEALTH DEPT: REQUIREMENT
'�,f1� �L •.�
31. Plaster Brown Coat '. � ' ' ' i�{�� F 79,' FINAL INSPECTION�, � � � �- ' �
,� e . I i.• �J -i I� I t! ��
� - , _
32.�Electrical.Pow6rMeter�Final: �.•' ! �i :.#; i���rj •�80.�FOODCERTIFICATEISSUED
33. Final Electric '' .. ' � ' 7,/
} ` ��. � "Notes: � �
r ♦
34. Final Heating & Air�Conditioning. , � � ��i� �j ; �s�. �;,� � p�
�i6/_
35. Fin0l�Gas�Pipe=Test. ' '� ' .�/ %'1 " �-' _
� , � , ,) '1 CY , . � a•,
� � � �
„36.'Hood orCanopY �" � ' � � . , . % : . '
. � � „
'37.'Final�Fa'aorv FireP�ce', . ' , ' .� . ' �`� { , '' ; . • ,• . .,.
` ��
38. FinaliPlumbing .i ^ � � ��.� � i I I' ' ' � � �
39.�Water� Service�Final � � � � � t � �� ��.
� �i f : -,pnm i
40. Gas'Service•Final � � ''� I � �; " � �
,.� . i �n i . � . . .
41.�Solar pomestirFinai .. � � ••ri � i � � _
, �,� ' f. s r : �
42.�BackflowPreventer�' • .' ,.�;.' �' I � �f : ' � _ : �
43. BackElow Irrigation s • • + + , - + . � ,�
� � • . . . .
44. LandsCape Irriqatioq System ,,; �� ; , � , , � , -,,. ,
, . , ��; . ,�i .
45. Sound Attenu3tion' •'i � �� � . � ' i + � � � � -i '
i.t ��i � � i � i-� - • -
46. Handicap Regu�ations � . , � �'� ' '� ' ' ' , . '
; � ' �; .
47. F.INAL STRUCTURE & BUILDING �� .• i � i �. � - � -
G ue ,� :, . , � .
48. FINALPLANNING ; , '`"�.� ...,� �,Y�; .' .., ' ,
49. Electric Release to Edison /; �" .
�
`ly�' /1�1�t �.� . .
-50. Gas Release ta Southem Califomia Gas Co � '�� '�� �'�'� � . ,-� . ' . ; , , , .
. .- ,
51. CERTIFICATEOF'OCCUPANCY ; , , „ r, , , „ .,,
No� Date �
� I
zLopEss: 396 E 18TH ST
wxeA•sH�Me: SUZANNE GILDRED
nooxess:616 ST. JAMES RD
NEWPOAT HEACH, CA.
' 714/646-9286 •
RPLHIENOINEEB: flE0.N0.:
' IIOOPESE�
uxrt:
uxrt:
PExrniTTEE: SUZANNE GILDRED ( 714 ) 696-9286
nooxess: 616 ST JAMES RD
NEWPORT HEACH CA 92663
LICENSEO CONTMCTOB UECIAMTION: 1 hareEy aRirm ihat I am Iicense0 under D�ovisions of CAaptei 9(commencinp wit� Saction
7000) ol OiviSion 3 of iha Busine99 anE Pmte55ions Code, an0 my license is in NIIfOrce and ¢flecl.
ciir uc.: slere uc.: cuss:
Data: SiqneWm:
WONNEIIS' COMPENSNTION OECLAM710N: I hereEy attirm that I have a ce�wte oi conun� to ull�insure ar a ceNficate ai Warkers'
��pensation Insura�ce, or a cMilieO copy t�ereol (Sectian 3800, Lab. q.
�f;+�dCY NO.: FJ(P. ORTE:
❑ CeNlietl wpy R �ereEy fumLtAetl. ❑ Certifietl coOY � fileE with Ue tiry BuilOinp DiWsbn.
Oate: MD����
IXFMVf10N FIIOM WDNIIENS' COMPENEATIOX DECLAMTION: (ilis uciio �reeU m� Ue comD� i� Ne pei i� 5 �a one �unEreA (f1 ') a Im).
I cenity Itut in tne pehormance ol tAe work lor x1uch IttiS permit is is 0, I sha0 noI em0�' �Y Der n in any manner s I Oecome
SuEjec� �to �Iha W�or�kers Copmpensmion Laws ot C
-Oate: /1� —� � ! � �0�
NOTICE: II, atle� �Wnp this Geclarafion, you sAoultl Oecam ' p ro t�e WOM s' Compensatlan O�ahsbns ol tne LaDor
COEe, you mus� torlMvit� compty wIU wc� O��b� or mil SAall Ce tleemeE rewkeE.
CONSTRUCTION LENOINO �GENCY: I �ereCy attirm t�at Ihere cans[mction IenOinA agency for the peAormance ol Ue woM lor
whic� this permit is iuue0 (Section 3097, Civ. C�.
LFNOER:
RDDPESS:
CZTY OF COSTA MESA�— BUILDING PERMIT PERM NO:, E 049255
PERMIT NO; E 049255 PLAN CHECK NO: N GOVT; N.SUPP: N
CONSTRUCTION TYPE; " PERMZT TYPE: ELE P,URPOSE: OTH
JOH DESCRIPTION ; MOVE ELECTRIC SERVICE � SQ FT:
CLAIM VALUE: CALC—VALUE: � GAOUP OCC;. /
COMMENTS: METER MOVED FROM GARAGE TO HOUSE
x�e**x *+rx*�r*���rx�r�e�rx�r�r*�r�r�t*�e�r�r*�r***+r�r**��r�**�r�+�**��r*�e**x+r x�+r+r�*�+r*�r*�r*�r*�+�*x�*�+r�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S � . ''
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT 2N REAR; FT IN 'FRNT; FT IN AEAR;, FT IN
LEFT; FT �IN RGHT; FT IN LEFT: ' FT IN RGHT: FT IN'
PARKING REQ• PROV; PARCEL: 00000000 ZNE: AEF NO: � �
PLANNING NdTES> ,
� . . . ' " _ _ ' .'
it it fk i! if k iF ik iE if iF it it 1F iE iE it k it ff iF it if k it fk ik 1F if k if iF iF k iF_iF iF iF iE 3F iF iF it Ik ff iF ik iF it 1F ik if ih iE if if M if M if!! iF iE if iE if it iF iE iE 3k iF iE iE iE if if 1E iE
D E V E L O P M E N T S=E-[t V I C E S R E Q U T A E M E N T S'
ZONING APPROVED BY ' +` ' DATE:
HUILDING APPROVED BY ; ' -- DATE:
APPLICATZON ISSUED'HY: — _ DATE: �a I (x�
MlFifiFiklfltifiFililifMfkikiFiFikkikiffF . ilfEikitiflfikiEiElf i(�{E
ik iF ik iF iE if k ik iF iFlf if i! ik iklf iF iF ik if ik f! fE if it ik 1E if ik iE Ik ik iF iF iF ik �F �F ik jF M ik iF ik i! ik iF iF If iE iE 1F iF M M �F if M if fk iE if iE if iF iF iF ip 3E iF �t iE if iF iE If 3k iF ik
LEGALIZATION:N F E E_ S U M M A R Y STRUCTURAL SEGMENT:N
OWXEPBURDEPUECUJU710N: I�erebyaKirmthatlamexemptiromt�aCanlraclars'StateLicense�awtorlheiNlowmpreamn BLDG PMT PLUMBING ELECTRZC �MECHANIC FIRE �SMIP/RES GRADING
(Section 7031.5 Business antl Prolessional CaAe: My city of counry which requires a Dermit to constmct, altar, Impmve, tlemolish, or p ERM I T • 18 . S 0 � '
repair any simcture, D�or ro IB issuance, also rtQuires t�e aDP�icant for suc� permrt to lile a sipnetl statement that Ae/she I5 Ilcense0 , �
pursuan� Io Ihe Drovisions o� Ihe ConVaciors' Slaie Licensa Law (CAaD�er 9(commencing wit� Section 7000) al DiNsion 3 oi Ihe Business ' � S 0 Z S M I P/ NON —R ES
and Pmfessions Cade) or that he/s�e Is exemD� ��ereimm anA t�e hazis lar t�e allepeE exemptlon. My violation ol Sectian 7031.5 hy PI.� .
any apDlicant lor a permit suUlects the applicant ta a civil penalry of not mo2 than fiva hunara0 Oollars (5500�. _ � ZSSUE FEE � � 15 . 00 � �
I, as owner o� ma oropeM a� my emplayees with wapes u meir wie compenution, will ao tne wark, ane the HUILDING-DIV—> PERMIT ISSUE PLAN—CHECK � TOTAL PAID ' ;DUE
struMure is nai inlenUeE or ottereU lor 5ala (Sec�lon 7044, Bu51ne5s anA Professional Code: T�e Con�roctors' State L�cense Law TOTAL S----> 18 . 5 0' 1 S. � 0 0. 0 0 � 3 3, S 0 � 3 3.$ 0 , 0 �
Aaes not aDPly to an awner al a DroDeM �o builds ar improves t�ereon, an0 wAo Oaes suc� wad �imsell/hersell or Ihmuph , ,
�is or her o� employees, D�a�4eG IAa� suc� impmvements are not mien4e0 ar attere0 for sale. II. however t�e GuilUlnp or
imOrovemen� is soltl wit�in one year af completion, tAe owner will �ave Ne hurAen ol provinp Ae/sha did nat bui10 or improve AEV ENUE D I V I S ION TOTALS--> COLLECTED : . 3 3, 50 OVEFZ / SHORT : • 00
mrteepurposao�sa�e�. HLDG PMT PLUMBING ELECTAIC. MECHANIC FIRE SMIP/TOT GRADING pLAN—CHECK
' I, as owner 0� ��a Dwperry� am exclusivery wmractinp wiN licensed contractors to constmct [he D�olect (Sectlon 7044, Business 3 3. 5 0 .
� arq Prolessiau CaEe: The Cantractors' State Lkeiue law does not appy lo � wmer ol property wlp UUYEs w imprwes tnereon � ' �
anOwliocontrzctstorsuchDrol�u�t�aconlranohs�licensepursuan�rotheContraclors'SlateUcenSeLaw).lamewaa 1tiFikiEl�itiEil�iE1liEiFi!{E**M.*{f******kil.;.�F*****�.**it******�.*�.**��.*..x.***.**{�***�.**,**,****�,�,***,*,�,*,
mat praol o� their Worker's Compensauon insuranre snoule he prmdeea ro me. I N D I V I D U A L F E E B R E A K D O W N �
� I arti exemp� ��� SecGon: B. 8 P. C.
�ormisreason: " TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Oate: �D ���' q(7 � ELE 1 SERVICES HELOW 600 V 6 HELOW 201 AMP 18. 50 � 18.50
I Uo �ereby certiy Itwt I am aware of anE unEerslarM the reyuiremenis af Calilomia Ne anE Salery CoEe Sections 25505, 25533. anG
T5534 anE tAat I or a�y NNra OuilOinp acupant xiNwill not (drde one) need ta wmph/ wSl� salO�e mEes aM IAe 2puirzmenis tor a
permit for constructio� m maEifiwtmn hom t�a Nr Ovaliry Man�OisUict BeSiAentlal co ction aPWicat/ions )are ecem7t Irom
these Drovislons. �.Q��e�f�
Oate: �� �' / ^ / � �1pDlicant: �M9s✓
I heleby cErtity Ihai I Adve Ra0 INS ap0���i0n anE Slaie l�—a� AB a�0 nformatlon is conea. I apree ro wmOb �� an ciry anE counry
O�di�2nG¢52ntl 512I0 �aw5 fEWIIOp �0 �WlEinp COM1StNtf100 311A h¢2 uthonze reDauntalNes of crty ro enter u e a�mentlone0
Droperty br inspection Duryous. �
Oaie: �(�� � / D $iqnaNr /
oriver's ucense or 6ocial Secudty x:
189La8 W�ita—BYlltlinp; Oreen—COEa Eniorcement; Cenery—Applicant; Pink—Revanue: GoltlanroE—AssBasor �
'�---`-1 � �� .
0
END OF FEES
0
0
�s ��op;a�4s-n�,a�a�as ��-� ,,.;,,,,
�ATE, 1Ji6Si6t1 TIME: 1��4?
- � � r
- CONSTRUCTION AND PLANNIN. - L& SPA�
APPROVALS Permit # Date .Inspector qppROVALS Permit # Date Inspector
�'
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -
;2.7Soil Pipe�Undrg�nd� 53. Steel Reinforcement � -� ' �
-=�3`Electrical ConduiF�Uiility-Undrgmd. J 54. Forms ' 'i'
.,�.
�;,: -
��'4._E�ectrical Cond�it�C�Jwdrgrnd. � 55. Electrical Bonding � : �
��5. Steel Reinforcerrient 56. Rough,Plumbing & Pressure Test o
�n i , �, .�. .-�
.'"6..`�,-`Elect%ical UFER`�Gf:od. 57. APPROVAL TO COVER�GUNITE o
1d.rF,00tings - � 58. Electrical ConduibUndrgmd. '� !�
^'8.'Foundation CN 59. Gas Pipe, � Undrgrnd., Test ,
9. Water Pipe�Undrgrnd. � � � 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. Sewer Cap � - - 63. Heafer & Vent�Final � . . � .�
13. Roof Drains � �O '
• rp /'" 64. Plumtiing SYstem � Final
14. Rough Plumbing 65. Electrical-Final �- -
w
15. Rough Electric`al-Conduit 66. Solar System-Final '� .
16. Rough Electric,Wiring 67. Fencing & Access Approval • .
17. Rough Wiring $ign � . ' 68. APPROVED�FOR PLASTERING
18. Rough Electricai-T Bar Ceiling ' . 69. POOL/SPA SYSTEMS F INAL
19.,Rough Heating &,Air Conditioning FIS [3E�T. REQUIREMENi,
.., r. ., x [*' -. C C x ca s c; a: �-7 C Fr-. -,... �.
� .i w �, •� v � �.. -. r '- �S � Q M. X ?�
20 �Fiou`gh Facto�y Fyreplace �r- ��q * S H c��: *�PPRO,VAES;HFPQ�P��� #
�n < +� .` T <"'+ �-! �^ a•
21_'Duit,in5tructurer HC f: ^�;� yx;M -1 �i'^jy �S x
r. ,.? r __� �� * ,r, n�; � "70. UPdergroSndyHyaro �
22_-Ducts, Ventilating;* � ���;� �: � � ,�^„ E�`.x z 471. ProducT�Plping O�Gas O�OiI
..
23 �Gas-Pipeiiough &,Fest �+^ � � `� �* * 2. Undergrosnd Flu h`� * "'
: i :_ x . m n- a�, � c s�c �: � s � a: >
24��Root FrBmin•• "K � `~ ;i'� �`� r- � � � ~ -
9 h� -�M * ••73.'-Undergrnd.Storag�7ank �Gas ❑Oil
25. Roof Sheathing =�'� 'Q v 'T ~ � => n'X � ^7q�'Overhead Hydro�' �
-� r.� Y ., �; m._. x.� s c x
.] - - s '-i H M �_i M .r �T �-+ t � �v
26.yT-BaY Ceiling (Stl�ctural) &'Nlpnocoat ;: p � •,.,r. r; 75�ry Chemical F� � m
27'..Frame arid Flashirt�,qK =�� y � '� �* " 76. Dry Stan "ipe `'� � ~ �
�1 r, c u F. M C�' .K i+ Y a: r.f' H '�K O N I-r
K v: "7 c." w. r.', K 2. . .. �� c r, n� .' [ i
"28. Lathing,& Siding;,,; �u; c, p x � I v: z: 77: +FIXED 5:153TENU.�JNAL� H n a1
r29. Insulation Cx� v S " " V � � 78�FIRE PREV. FINA'�L '' � C ^
,:� -, �S � I ���: v . � d
'�30. Drywall;Nailing ���t� Fy i *_. � � y: a S HEALTH Q,�PTzF�EQUIREMENT
G31. Plaster Brown�Coat= = `•T * I I �� T79. ✓FINAL If3�F€CT16N' Y �
✓ r^ r I � X . C� �..�J .l: 'J �+
'.4,�`32..Electrical�Power Meier F�,tnal � y �� I s: f'SO.mFOOD CERTIFIGQT� IS�Il�D �-, o
i33�Finai Elettri6> H�� r^ �. �+ � x No e5:• `"`� '��' '" �� `J �
r v t'. : r, � i..� u Y: � � ��: I c� rJ . C1 k .� S
'< <i # i: C, •'J • S . S i: S
H34 �Fina't Heatinl& Air�Con`ditionrngS z, �; ., � � �� zi ,.�^�p p. :,,� x; •
• - � .: . ,. � -._. _ r.
�35�'FinaIGaSPipe-TestrC?� � s?`'' I I t�, y^ ^�� C^ �,_, ��"
i .ai:
z36. Hoo� or Canopy",� � i�•; o x� I�-t+, x E � !�o � `7T
s �: n :�x c+; o � �-� x tr� x o �� :n O. :
37.JFinal�Factory Pireplacex :[�F o *�� i !s i� i� 5S
- x r� I t tY *�c' rr x� �n
' T �: y N ' O * ' ' i% fi 5 H 3: 37 U
538. FinatPlumbing � �,., c ,� I � i,y, * � �y �; ,: ,
�
`'39. Watei Service�Final:;; g i ��x ' � �t: a: >+ � w� 7' ^ Q
� � .t x c. w � '^ �
;r k Ctl 'ri C+� :" � i. [r; � � % .. � f ...: f.l Ci% x . . �
40. Gas Service-Final ���: ,� � � � I„ r F• o?� * 4
�R1. Solar pomesticFinal � �r. i: � I � � x t*� ;o c' t'�:
y i1 i w
� 42. Backflow Preventer�: • c� ^: ^ � � x" a '•`� * � `-+
tJ K Cli �HH y: H % i,: ;n ;r�G �e e. ti
43. Backflow trrigatlon�e � f� i� x ��i� A'+ ' r� '"• '
r.. r-� r. v: c.. f� * 3 i1 �11
T^ .,. C7 C+7 C� C". .1: ,n. ^-t :_t v�: k C� N f� .".� r '!: iU ..
� 44.�,Landscap'e Ir`ripation System�� ... h .� � �d �* ,: _; E s' p� :�: � �
{ l, >: r�•..r . r c- c� r-� , - _, ..
'`45.rSound Attenuation�: ; •• •• * !-; t�? ;,-,� �k 2� c^ Q . =p ,'
r n .. r; n �+� .. i-a r
C46.�'Handicap'Regulatioxs " ' * * �' �^ " �''c � �
< � x� i k��Z !*' U 7 �
,47.`FINAL STRUCTURE & BUfCDING j!T � �
�
}: : � � /"Y: %' �.. 1 � ii: L-�
' [�� c nt r-� Y. :i
48.�FINAL PLANNING�*�' `•^�" * "' � � '� * ``� =" r � "
� ��'�!: �' CJ � � .J S �•".
`49.�.EIectFic Release to �iJison . � � � '�y": x m � •c� * • "
. / n P fl !) `^ Y /�!
50.�Gas_Release to Southem CalifoiiM1iaGasCo � � ' ��i�� ;. `; � �� �': � N ,
�51. CERTIFICATE OF OCCUPANCY '" � I
No. Date
l�l I
�
�
PfliTJECT AODpESS: 3 9 6 E 18 TH JrT
'OWNEH'S NAME: $UZANNE GILDRED
nooness: 616 ST 7AMES RD
NB CA 92663
646-9286
PPCN/ENGINEEB:
FDOHE55:
flEG.NO.:
uxiT: CZTY OF COSTA MESA — BIIILDING'PERMIT PERM NO; H 05084`
PERMIT NO: H 050845 PLAN CHECK NO: 00424-91�5 GOVT: N SUPP: N
CONSTRUCTION TYPE: 6'—N PERMIT TYPE;.STR PURPOSE: OTH '
UNIT:
. PERMITTEE: SUZANNE GILDRED ( 714 ) 646-9286
aooxess: 616 ST JAMES kD
ND CA 92663
LICENSED CONTNACTOH DECIANAT10N: I hereby allirm that I am licensetl untler pmvisions o� Chap�er 9(commencing with Seciion
7000� oi Div,sion 3 otihe Business an0 Professions Cotle. antl my license is in fulliorce and eifect.
CITY LIC.: STpTE LIC.: CWSS:
,Oate: � Signature'.
}lOflKEflS' COMPENSATION OECIABATION: I hereby aifirm Ihat I �ave a certilicale of consenl �o self-insure or a ceriifica�e o� Workers'
Compensa�ion Insurance. or a ceNhea copy ��ereoi (Seclion 3800. Lab. C).
' POLICY NO.: E%P. DPTE:
COMPANV: � �
� ❑ Cetlifietl copy is hereby fumis�ed. ❑ Certified copy is filea with �he ciry Building Oivision.
Oa�e- NpplicanP.
E%EMPTION FflUM WUFNEflS' COMPENSATION OECLAHATION: (Thi55eqion need nOt be tompleted i� the permil i5 forone hundre0 (5100) or IeSs).
I cehity that in Ihe pedormance ol the work tor whic� lhis permit is issued, I shall not employ any person in any manner so as �o become
sublep to tAe WorkerS Compensation Laws ol Califomia. -
Date: Signawre:
NOTICE: IL alier making I�is declaration, you shaultl become sublec� to �he Workers' ComDensa�ion provisions ot ��e Labor
CoOe. you musl forthwith Camply wilh such pmviSionS or t�is De�mi� shall be deemed revoke0.
CONSTPUCTION LENOING AGENCY: I here6y affirm that �here is a conslmction lentling agency �ar the pertormance of �he work br
wnich this permit is issue0 (Section 3097. Civ. CI. -
LENOEP:
aooeess:
JOB DESCRIPTION ; PATIO COVER SQ FT: 321 '
CLAIM VALUE; 2,000.00 CALC—VALUE; 4,429,80 GROUP OCC: R-3 /
COMMENTS: PATIO COVER
��rx�x�� x��r�x�**�r**+�x �r*******��x ��r�***�***� ***�**�r �*�r�� �r**�*�*���***���r�r**+�*�r�r*��***
Z O N I N GS ERT�H�AUCIKRSE M E N T S
=----------- MAIN HUILDING ---------= --------- ACCESSORX BUILDING ---------
FRNT; 14 FT IN REAR: 5 FT IN FRNT: FT IN REAR; FT IN
LEFT: 10 FT. IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN
PARKING RE�• PROV: PARCEL: 11729138 ZNE: R1 REF NO: �
PLANN7NG N TES> 321 SF YAT'IO COVER THAT' F.NCROACHEI) INTO FRONT SETAACK
> 6 FT. SEE PA-91-08.
*****�t***�rx�r*****�r*�rx*x�*+t�*+�*+r�t�r�r****�r*�***�r*�+t�c�rxxx�t*x��r**x���t*��r**�*�t*�c�*x**�r*�t
D E V E L O P M E N T S E R L I C E S R E,Q U I R E M E'N'T S �
ZONING APPROVED BY ___ ��--� DATE: 07�"Li9 I
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: ' DATE: �'
if iE iE if iE iF iF ik �E 3E 3E 3!!E iE iE iE iE iE iF iE if if FiFiFiFiE {t iE iF iE iE 34 fF if !E�'iFiF�FiE i(�
iEiEiEiliEiEiElfiEitiE3FiF*iEikit3EiEltiFiElEiEiE1EiE9 �F3EiElFiElE3kiEifit fiFibiEiE3E�FifiEiEiEiF�iEifikiEiE:iE3EifiEif*3FiE3fi63EiFiEifiEifiE9f3E
LEGALIZATION:N F E E S U M A R Y � STRUCTURAL SEGMENT:Y
G
IowNEH euaoex oECU1HATiox: i nereby afiirm inat I am exempt �mm ihe Comracmrs' State �icense �aw for ihe �onowing reason BLD PA'�'1' PLUMB ING ELECZ' C MECHANIC � F IRE SMIP /FifiS GRAD ING
�Seclion 7031.5 Business antl Pm�e'ssional CoOe: Any ci�y ol county which re0uires a permi� m constmc�. al�er, impmve, tlemolish, or PERM I T % 2, � � ' . rj Q
repair any s�ruc�ure. prior Io rts issuance. also requires the applicant �or such permit to lile a si9netl statement ��a� he/she is licensetl . ' SM I P� N�N—R EJr
pursuam m �be pmvisions o� ihe Contrac�oK State License Law (Chapter 9lcommencing wii� Seclion 7000) o� Oivision 3 0� the Business pLAN 9 6. 8 �
antl Pmtessions Catle) or �ha� �e/she is eaempt thereirom antl ihe basis fa� ��e alleged exemp�ion. Any violaiion of Section 7031.5 by
any apD�icam �or a permil sublects Ihe applicant lo a civil penalry of noi more �han live hundreA dollars (5500). I SSUE FEE �
/ �. �as owner o� �ne pmveny or my emp�oyees wim wages as �heir so�e compensa�ion, will Oo �he work, and the BUILDING—DIV—> PERMIT ISSUE �PLAN—CHECK TOTAL PAID - DUE
' '� ❑ simclure is noi inlentled ar olleretl tor sale �Sec�ion 7044, Business an0 Professional Coae: The ConlractorY Slate License Law TOTAL$----> % 2, 5 � � 0. � � 4 6, 8 0 119 , 3 0 119 . 3 0 , 0 0
does no� apply lo an owner of a pwperty who builds or impwves thereon, and who tloes such woB himsel�/herself or NrouAh ,
his or �er own emD�oyees. D�ovitletl ihat such impmvemenis are not intenAeJ or offeretl tor sale. If, however ihe huildinA o� REVENUE DIVISION TOTALS--> COLLECTED • 119 . 30 OVER/SHORT • 00
impwvememisso�dwithinoneyearo�comp�e�ion,theownerwinhavemeburdeno�pmvinghe/shetlieno�buimorimD�ove BLDG PMT PLUMBIN('i ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
lor ihe purpose ol salel.
I, as owner o� �he pmpetly. am'erClusively COnlraCting with licen5etl ConVat�or5 to tonsimt� �he pmlec� (SeC�iOn 7044, Bu5ine55 7 z• O O ' • , 5 � i 6. 8 0
❑' antl Pmfessions Cotle: The Contraciors' Siare License Law aoes noi apply �o an owner o� pmpeny who butlas or impmves Ihereon
antlw�oconVacls�orsuchpra�eciswithacontractor(s)IicensepursuamtolheContractors'S�ateLicenseLaw).lamaware �'�'�"�'x"M"If*if'i("lEi(':x"N'�('i('*N'�('#i['i('#iE'K'*i!'1Ei("lEiE'x"K"1E'x'3f"x'i("K"x'if'!E'1E#'1F#K"%IF'1fiEifiFit�f'1EitiFif'1EiFiFlf7EdEiE�IflfifiFlklEif�lf3f�1E�lEifiE
mat omo� ot meir woruer's Comnensation insurance shoNd be pmvidea to me. � I N D I V I D U A 1. F$ E B Fi E A K D O W I� �
� I am exemp� under Sec�ion'. B P�] Q.'� Q 8. 8 P. C. �
mrtnisreason: ALL WORK BY OWN � YPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Oaie:_�,�L�g� �� SFR 321 RES—PATIO COVER—POST & SOLID ROOF 13.80 '�9�429,80
t Ao hereby certify Ihat I am aware ol ana under5iand I�e requirements af Calilomia Hea and Sa�ery COAe Sections 25505, 25533, antl , END OF FEES
25534 antl �hal I or anY �uNre huilding occupan� willlwill not (circle one) neetl �o comply with said Slale cotles and Ihe repuirements for a - - , • � . ,
permii lor conslmction or moailicaiion imm t�e Pir Oualiry Management �isVict. flesidential conslmclion applicaiions are e�emp� Imm ' ' , �
ihese pmvisions. � .
oate: AOPlicam:
I here�y cer�ify Ihal I have reaA Ihis applicalion antl staie that �Ae abo e in�ormalion is mrrecL I agree to compty wilA all ciry an0 county
ortlinances and s�ate laws relating lo builtling cons�mciion antl here0y horize represenla�ives of t R ci�y nter upon Ihe - niianetl
propetly forinspeclion purposes. �
�Date:J—e�fY=_[_�_ Sigi �
Drive�'s �icense or Socia� searity x:
1641d6 Whi�e—Builtling: Green—Gotle Enforcement Canarv—Apolicam: Pink—Revenue: Goldenmtl—Assessor
I
n� a�n��tib�-or,a�5,ba �-�.A-�
t}ATE: pf/3Q/9: TTflF.: iu:42
/ \- � �
. CONSTRUCTION AND PLANNirvG - � POvI & SPA '
' ' Date Inspector Date Inspector
! APPROVALS Permit # APPROVALS Permit #
"f` 1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Location •
2. Soil Pipe�Undrgrnd. 53. Steel �Rei�forcement
3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms � �
� 4: Electrical ConduibUndrgmd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test'.
' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
'8! foundation - 59. Gas Pipe. O Undrgmd., Test . ,
9. Water Pipe-Undrgrnd. .. 60. 8ackwash Lines, P�Trap, O Undrgmd. �
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 Piumbing ' 65. Electrical-Final , �
15. Rough Electrical�Conduit 66. Solar System-Final „� �
16. Rough Electric Wiring 67. Fencing & Access ApP�oval .
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 Pactory Fireplace • '�' ' ' • � � � : APpROVALS • � Permit # `
i�
21. Ducts, in $tructure_ ��.-. .�� A0. Underground Hydro �
22. Ducts, Ventilating • � � ;� 71. Product Piping O�Gas O�OiI
23. Gas Pipe-Rough &'Test . � �� . ,. , .7p, Underground Flush. , . '
24. Roof Framing ; i ��• ' � 73. Undergrnd. Storage Tank AO Gas ❑ Oil �
25. Roof Sheathing ' � 74. Overhead Hydio `
26. T�Ber Ceiling IStructural) & Monocoat 75. Dry Chemical ' �
27. Frame and Flashing" , . . '; , 76. Dry Siandpipe , . � '
` 28. Lathing & Siding � _ ' � �. •� 77. FIXED'SYSTEM FINAL' .
29. Insulation �� � .. ' j ^ i: . 78.• FIRE PREV. FINAL -
30. Drywall Nailing ��,� � �� ���;. � � HEALTH DEPT•. REQUIREMENT -.
31. Plaster Brown Coat '�� i �;��; � 79: FINAL INSPECTION , � � �
32. Electrical Power Meter-Final� �
t�I �':�' I' 80. FOOD CERTIFICATE ISSUED _
33. Final Electric ' 'i I `p ; -�Notes:� , � _
�34. FinalHeating&Air:Conditioning� � I � �,�.�� � •% ' ,�
/� , t . i� /
35. �Final Gas Pipe-Test' � ' � � �' } �� ' ' _ . ' '
t.�1�i � -
36. Hood or Canopy � . , . , � i ; � � t � � � � � .
37:�Final Factory Fireplace - . �,��� �i,'�,�'�' ` , �
38. Final Plumbing . 1� � I�� � ,
39. WaterService-Final• • �'� .� � � l � -
40.� Gas Service-Final . 1I I'�� . _ �
41.�Solar pomesticFinai � �• j � � � � �
i I i
42. Backflow Preventer, � , � I �� ; �_ , 1
43. Backflow Irrigation� . � ' • ,
'44. Landscape Irrigatio�n System � - -� . i � .
45. �Sound Attenuation ' �
'46. Handicap.Regulations � �� . � �. �
47. FINAL STRUCTURE & BUILDING � 3� �i � _ �
48. FINAL PLANNING �JI I �. .
49. Electric Release to Edison ,-.�i' � f i
50. Gas Release to Southem Califomia Gas Co , 1� � �j� � . 'i. • . . . � . '
/�
� 51. CERSIFICATE OF,OCCUPANCY ; � . � • /
No. Date