HomeMy WebLinkAbout1691 BAKER ST - Building Permits et9 V Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 5179 4/01/87 5002, 1
CITY OF dress MESA� CO� FjUCTI,5)RMIT PER N �'/7 TRACT NO. LOT NO. UNIT NO, J
Project/Address 4 n A-ce? - ��� •
'4,Q-ni,e TYPE OF CONSTRUCTION U NEW U±ADD H ALTERATION U REPAIR r •
Applicant's Mailing Address
❑
py
Owner's Name .' • a PhRrlf 9CONVERSION El DEMOLISH El OTHER A.P.# Zone
�y /, ,,, DESCRIPTION OF WORK/USE OF BLDG.
Address /'&`7 / Pitkg 8-7, S Main Building: Accessory Building:
Z
Arch/Eng. License No. TYPE OF PERMIT U GRADING U U FOUNDATION STRUCTURAL E Front' - o
❑ TENANT El ELECTRICAL El PLUMBING ID MECHANICAL B - - N
AddressRear
❑ OTHER C Right - N
Contracto -'• -' . �•. x i hone�/�
/ PROJECT DESCRIPTION •SQ. FT. OCCUPANCY 9 G
Address(mailing) -s'y P /.t�'P-4 a/ I'd- K
/ � CONSTRUCTION TYPE VALUATION$ S Left •
City License Na ((D cis-3 / •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: - Ni
with section 7000) of Division 3 of the Business and,Professions Code, and - _
booM1— my license is in full force a • effect. r 3 S
W License Cla - Lic . No. M /(r ,
Date Signature ffir► i., :. 'PLUMBING FEES gEf EtvFfI MDQ q i MP
WORKERS'COMPENSATION DECLARATION
\A' 'hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers - ELECTRICAL - FEES
Workers' Compensation Insurance, or a certified copy thereof (Section - -Backflow Preventer Service'Sink Automatic Washer Transformer 0 15-50 KW
300, Lab. C.) q �J, / p�
. Policy No. Ot 0/ 7�(� Company SC __ZF Backf low Irrigation Sewer Cap ❑ 50+KW
fl Construction Pole Sub.
}j(Certified copy is hereby furnishetl. ,
Certifi tl c py's filed with the cityfsilding isie . Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date 7 Applicant C7f A� l�� �5?R/� - -
EXEMP ION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps
(This section need not be completed if the permit is for one hundred ($100) or Dishwasher
less). 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 Motors❑0.1 HP ❑1'h-B
Workers' Compensation Laws of California. _
Date - Signature Floor-Drains • Swimming Pool w/Spa —
F.A.U. Inc.Solar 09-15 HP 016-15+
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 Fixtures • Microwave
comply with such provisions or this permit shall be deemed trevoked.
•
CONSTRUCTION LENDING AGENCY 11 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. C.) Interceptors Water Heater ^
Lender's Name P �,C'D Outlets Range
k Lender's Address Kitchen Sink - Water Service Switches ' -
OWNER BUILDER DECLARATION •
Sign
I hereby affirm tha
t I amon exempt31.5from the Professional
License for the Lavatories Auto-Wash Garbage Disposal Standing Sections
following reason (Seco On permit
Business and Pro}Qss Code: Any city re Or '
county which requires a permit to construct,alter improve,demolish or repair P-Trap Laundry Trays • Generator ❑0.5 KW❑5-15 KW 7
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor
• to file a signed statement that he/she is licensee pursuant to the provisions of
Roof Drains
I1 the Contractor's License Law (Chapter 9(commencing with Section;7000) of
7 Division 3 of the Business and Professions Code) or that he/she-is exempt •
1 therefrom and the basis for the alleged exemption. Any violation of Section
1 :7031.5 by any applicant for a permit subjects the applicant to a civil
I pnaity 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 I $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
p , 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).
0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date
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 ❑700,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a con-
. tractor(s)'ucense pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ .-. SMTP $
I,proof off their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT �,p�/��,
I I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers - ISSUANCE $
- PLUMBING $ •
•o6
Date. HeatingSystem& DuctingRegisters '
I hereby,- Owner Y 9 PLAN CHECK 25% $ ENERGY P.C. $
InformatioP!tifv that I have read this application and state that the above ❑0.100,000 BTU ❑100,000 BT • ELECTRICAL $ GRADING .$
and state lets,correct. I agree to comply with all city and county ordinances •
sentatives o ,relating to building cons ruction, and hereby authorize repre- - PLAN CHECK 50% $ MICROFILM S
inspection purp:l$ City to e u e, above-mentioned proper y for
signature • _ •
MECHANICAL $ ' TOTAL FEE $ :��Q
Drivers' - .,'�L Date
license or SS YF' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMFOB 65-46,rev. 10/84White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
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 & Pt sure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Urtctr'grnd.
8. Foundation 59. Gas Pipe, O Undrgrn&I!Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Tra{U, 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 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing ' 73. Undergrnd.Storage Tank 0 Gas C 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 t-r-07 ,
39. Water Service-Final ,
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation • '
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed -
49. Eleurlc Release to Edison - • - '
50. Gas Relyse to Southern California Gas Co - r�
51. CERTIFIIATE OF OCCUPANCY
No.___---7-- Date -
t