HomeMy WebLinkAbout550 BRISTOL ST - Building PermitsCi7Y oF COS7A MESA CONSTRUCTION PERM�T '�' ,x,
ProjectAddress S� ��i,r'O�
ApplicanYsMailingAddress � S���QS'��n�
Owner's Name L Phone t'
Address \�� �G '�{ ��1� ��� Mr�
Arch/Eng. License No. 37 a 6s�
Address �� S�� �Q��+ S+. �J S�'�� CG Qo7in%�
Convacror'sNamr�(a�Pr�'S �C�2C��iL, Phone SU4-3��
AJJress (mailing)
Ciry License No. ��U S6q. �
LICENSED CONTRACTOR DECLARATIpry
I hereby ailirm t�at 1 am licensetl untler provisions ot Chartar 9(commancing
with sectlon 7000) of Division 3 of tne Busineis antl Protession5 Cotla, antl
my license is in full lorte anne eftect.
License CI ss C— " License No. "�`? o)F��3
Date Si9na[ure
�RKER ' CO PENSATION DECIARqTION
reby atfirm thai 1 nave a certilicate of consent ta Self-insure or a cerUflcate
. Workers' Compensation Insurance, or a certifiea copy tnereof (Section
3800, Lab. CJ
Policy No. Company
BCertifietl COpy is Ilefeby (uTiSh¢tl.
Cer[itietl copy is filetl witn the city Builtling Divislon.
Date AOP���ant
EXEMPTION FROM WORKERS' COMPENSATION UECLARATION
(This sec[ion neetl m[ be completetl if the permit is tor one huntlretl (5300) or
less).
I certi(y that in the performance ot the wor fOr which Ihis pe�m�t is ISSuetl I
snall not employ any Oersan in any mann so to ecome subject to t�e
Workers' Comp sali ws of CalitO ia
Date• ��2��.�Signature �_
NOTIC� If, atter mdkinq this tleclar io y0u zn0 tl ecomo Subject to the
Workers' CompenSatiOn Provision5 �bor Cotle, y0u mu5[ Iort�with
comply with such provisions or tnis pgrmit snall be tloemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby altirm that there is a construction Ientlin9 a9ency for the performan<e
Of tne work tor whiCh this permlt i5 ISsuetl (Section 309] Civ. CJ
l.entler•s Name
�entler's Atltlress
OWNER BUIIDER DECLARATION
1 herebv aitirm lhat 1 am enempt from tha Contractor's License Law lor the
UTereirom antl tne bails for the alleged exemption. Any violalion ot Section
7031.5 by any appliGant �or a pe�mi� Subjects th0 applicanl to a<Ivil
�enalty al not more than five �untlretl tlollars (E500�.
I, as own¢r o� the prop¢rty or my Cmploy¢ei wiltt wd9es as their sole
tompensalion, will Oo the work, antl the strutture is not IntentleE or offeretl
tor sale (Seclion ]044, Buslnlss antl P�ote55iOna1 Cotle: The Contracto�'S
License Law tloes not app�Y to an owner vl a property wtia builEs or improves
thereon, antl who tloes such work nimselt/hersalt or tnraugh his or her own
emplOyeeS, pfovitl¢tl tlfat suth ImprOv¢Tents are nOt InleOtletl or OttBretl tar
sale. It, however, [he builaing or improv@men[ is soltl withln one yaar of com-
plelion, the owne� will have the bu�tlen Ot proving h¢/The tliG nOt builtl Or im•
prove tor tne purpose of sale).
❑ I,-as owner oi lhe Oroperty, am exclysivaly con[rac[in9 wi[h litensetl mn-
tractors to construct the project (Section 7044, Buslness anG Professions Cotla:
The ConVaG�of'S LicenS¢ Ldv/ tloei nOt apply lo dn Owner 01 pto0elty wh0
builtli or improves [hereon. antl who coneracts 1or such orolects wilh a ron-
tractor(s1 licenze punuam to [ne ConVactorx Ucense Law). I am aware tha[
pwoi o� Ihelr Work¢r'S Compansatlon in5uranta ShOu10 ba provleed to me.
❑ I am exempt untler Secllon B. & P. C. tor this reazon
Da[e Owner .
I hereby certify thac I have reatl
information is corr¢ct. I agr¢e lo c
antl state laws relatj�g to buildin9
a� ill In all spaces except thosa wlthin heavy Oortler Ilnos anC sign all approDriale tleelarations.
P p, " TRACT N0. LOT NO. UNIT NO. A P,�y
� S Main Building:
aYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR � E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Ffont
DESCRIPTION OF WORK/USE OF BLDG. I A Rear
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL I C Right
c^ K Left
❑ TENANT ILI ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S
❑ OTHER Ping. Ref, #
PROJECT DESCRIPTION SQ. FT. OCCUaANCV Planning Notes:
GONSTRVCTION TVPE VALUATION $
ZONE GRADING CU. VDS. ACRES
Remarks:
Preventer
Irri9ation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Incercepmrs
Kitthen Sink
Lavatories
P—Trap
Roof Drains
Reinspaction Fee I $15
oiler
�uct - Under Ground
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO �
Heating System & Ducting
❑o-ioo,000 eru �ioo,000
,,,` - — -
Driv¢rs' Li n�,' 9f • � � Aeinspection Fee S75
0865-46, rev. 5/88 White - Builtling; Canary - Applicant: Pink - Accouniln9� Goltlenrotl - Assassor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Clout
Water Heater
Water Service
Auto�Wash
laue Faa
Hood or Typel ❑
Canopy Type Ii ❑
Refrigeration System
❑aioo,000eru ❑ioo,000
System Repair�Alteretion
Fire DamOe�s
Fiegisters
laue Fee
S 3
FEES
3
Automatic Washer
Congtruction Pole Sub.
Cooking Unit
Dishwasher
Dryers �Gas ❑Elec[ric
zo�a
Accessory Bui
Parking Req,/Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Fan
F.A.U.
Fixtures
Device Boxes
Outlels
$WitCh¢5
Garbage,Dispoul
Generetor �0-5 KW �5�15 KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motars �P7 HP �1 Yh - 6
Inc.Soiar �9-15 HP �16-15+
Microwave
Pole Light
Range
Slandin9 Sections
Trash Compactor
FEES
O
N
I
N
G
R
E
�
M
T
S.
� Reinspection Fee � 515 � � Issue Fee I $/$ I
DEVELOPMENT SERVICES RE�UIREMENTS:
Zoning Approved By Data
Building Approved By Date
Application lauad By Data
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PIAN CHECK $ PERMIT
PLUMBING $ ISSUANCE 5
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $•�,��' GRADING 5
PUINCHECK 50% $ MICROFILM 5
MECHANICAL $ TOTAL FEE $• �. �
PVaNCHECK 25% $
�; Qd�38=,:3-��cD:6513 '?t'�? . . -
�C-s: "L,'2�.•_9 TTii_: _.a; �_
. .�
CONSTRUCTION AND PLANNING •� PO .& SPA �
APPROVALS Permit # Date Inspector AppROVALS 'Nermit # Date Inspector
1. Temporary Electriral Service or Pole 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. . � 53. Steel Reinforcement ���
3. Electrical Conduit Utility-Undrgrnd: 54. Forms -,
4. Electrical Cond'uit-Undrgrnd. �� 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -,
57. APPROVAL TO COVER-GUNITE '' "
6.��Electrical UFER Grnd. .
7. Footings, `' : 58. Electrical Conduit-Undrgrnd. ' �
8.; Foundation , 59. Gas Pipe, O Undrgrnd., Test ,
9� Water Pipe�Undrgmd. �~ 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
73. Roof Drains � 64. Plumbing System - Final
14. Ro�ugh Plumbing 65. Electrical-Final � ..
15. Rough Electrical-Conduit 66. Solar System�Final
.� 76; Rough Electric Wiring 67. Fencing & Access Approval
�17: Rough Wiring Sign ' ' 6S. APPROVED FOR PLASTERING
18.. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
.1.9.. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
26t Rough Factory Fireplace � APPROVALS Permit # ;
-t-
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating �, 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Framing '' 73. Undergrnd. Storage Tank O Gas ❑ 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 MeterFinal . FOOD CERTIFICATE ISSUED
33. Final Electric (O � tes:
�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 pomestic-Final _ , �
� 42. Backflow Preventer --� ,
� 43. Backflow Irrigation �
44. Landscape Irrigation System �
45. Sound Attenuation
46. Handicap Regulations .
47. FINALSTRUCTURE&BUILDING ' "
48. Special Requirements Completed
49. Electric Release to Edison .'
50. Gas Release to Southern California Gas Co .
51. CERTIFICATEOFOCCUPANCY ' ' �
No. Date . , �