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Home My WebLink About1609 BAKER ST - Building PermitsCITY OF COSTA MESA Q0o"a"'F BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 - Fax (714) 754-4856 • www.costarnesaca.gov Q� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE B_ROOF2 APN: 13919312 JOB ADDRESS: 1609 BAKER ST CM Vicinity: Squares: 0 PERMIT NUMBER: B12-00178 STATUS: APPLIED DATEISSUED: ISSUED BY: CAC Suite/Unit: Valuation: $7,300.00 SCOPE OF WORK: TEAR OFF 2 LAYERS OF COMP SHINGLES INSTALL 2 30LB FELT AND LIFETIME COMP SHINGLES NOTE: RESIDENTIAL RE -ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: HUGO AND TERESA RENDON PHONE: 714.751-1226 APPLICANT: MARIO GUTIERREZ PHONE: 877-997.6635 CONTRACTOR: SUDDUTH CONSTRUCTION INC Address: DBA GUARDIAN ROOFSUnit: City/State/Zip: 1651 E 4TH ST 92701 ARCHITECT ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $153.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 Address: 1609 BAKER ST Unit: City/State/Zip: COSTA MESA, CA Address: DBA GUARDIAN ROOFS Unit: :ORANGE City/State/Zip: 1010 N BATAVIA ST License No. 847279 SANTA ANA, CA PHONE: 714-423-1623 CELL: License No. PHONE: License No. PHONE: FOTAL FEES $154.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal holiday; New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODEr. INSPECTIONDTE QAIE QORIALS CODE r INSPECTION TYPE Q,11E tNTmAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final �o ( L 2 Final Plumbing 200 Final Re -Root 8 2 DA -21010 Final Electrical 201 Final Bloddiletaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Omupancy ' WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this P is issued. My workers' compensati n Insurance carrier and policy umber r�� neral not be m=inpbred Erne pemur a valued drone hiadretl dolars (SIM) orkss.) Por' Nu r:OC) Zc4U 27— qy ❑ 1 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 workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. 7-27— I.7 lirant's S nature to WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and 9nse is in full force and effect. '=R -727 # BI C39 Contracvo .Sigrawre Dale CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature Date OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to Construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): Q I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). a 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the pmject (Sec. 7044, Business and Professions Code: The contractors License Law does not appy to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 3057ee (3101) Owner ID verified by drivels license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty -sic (36) feel high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Applicant's Signature Division of Industrial Safety Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a peril for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if 'yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (if 'yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penally of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature Data CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. i agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal Owners) Date �2 AnNor ulhanz.tl plicanl Delo CITY OF COSTA MESA BUILDING DIVISION 7 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 - Fax (714) 754-4856 - www costamesa6& QbJ_ FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE B_ROOF2 APN: 13919312 JOB ADDRESS: 1609 BAKER ST CM Vicinity: Squares: 0 PERMIT NUMBER: B12-00147 STATUS: ISSUED DATE ISSUED: 07/02/2012 ISSUED BY: CAC Suite/Unit: Valuation: $500.00 SCOPE OF WORK: REMOVE THE LAST 3 FEET OF THE ROOF DUE TO WATER DAMAGE. REPLACE WITH SAME AND REPAIR WOOD AS NEEDED NOTE: RESIDENTIAL RE -ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: CANEZ,TERESA PHONE: 714-751-1226 APPLICANT: CANEZ,TERESA PHONE: 714-751-1226 CONTRACTOR: OWNER -BUILDER Address: Unit: City/State/Zip: ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $23.50 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 Address: 1609 BAKER ST City/State/Zip: COSTA MESA, CA Address: 1609 BAKER ST City/Slate/Zip: COSTA MESA, CA PHONE: License No. 000000 CELL: License No. PHONE: License No. PHONE: Unit: Unit: : "OTAL FEES $24.50 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 - PER CMMC Sec. 13.279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal holidays New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE 1. INSPECTION TYPE pdIE INIAL$ CODED INSPECTION TYPE ME INTMAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1268 Pool Spa Final 208 Final Plumbing 200 Final RQ -Roof � 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 - Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS' COMPENSATION DECLARATION: I hereby affirm under pe�afiy of perjury one of the following declarations: ❑ I have and willa5iintal%a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are: Carrier: (ms seam ncod not oa mmP'a:ed d the permr is naked at me hcex$nxl dab. ($100) or ress) Policy Number: ❑ 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 became subject to the workers' compensation laws of California. and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Apptirant's signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (8100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lit. # Class # GontraaNs Sgnatwe CONSTRUCTION LENDING AGENCY: Q I hereby affirm that them is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature Date OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to Construct. alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500).): Q I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or Offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with Wa tractor(s) license pursuant to the Contractors License Laws.) Jd I am exempt under sec. Business,and Professions Code for this reason: Owner I verifier by driver's se. LJ'Yes ❑ D O err Licen No. Exp VerificaY of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend. will be made in connection with work authorized by this permit. and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Applicants Signature Date Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2. Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If 'yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. (If 'yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection pu oses. I agree noJJ,�tooccupy or allow occupa of w ny building authorized b is permit until;atinspectien. _„ gnetfeiD.M>al Ownerf s) COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA, CALIFORNIA fOR APPUUNT TO HU /N COMPLETELY TYPE OR PRINT BUILDING ADDRESS COSTA MESA, CALIFORNIA EE RECE''ED C✓✓ .iliw 3 Wuy FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING fOR Offlet usr ONLY OWNER RECEIPT NO. PERMIT NOO./ G I I 41 76- MAIL 1, o M ADDRESS cµ9 E. 1 th St♦ RECEIVED BY BUILDING ADDRESS ATE RECEIVED DATE ISSUED I ( ��"� I CITY Costa Mesa 'NO ARCHITECT LIG Carlson & COSTA MESA, CALIFORNIA OR ENGINEER NO, M:Lddlebrook IRE Z ADDRESS Garden Grove Grove. ONE ��jj��pp Cole rove Inc.STATE (, g 1"723 APPROVE I CONTRXCT0IR T" LIC. NO. BY Grr' �c L DATE ADDRESS 419 E. 17th St. Costa Mesa ZONING LEGAL LOT^ I I ZONE NO. OF I USE OF NEW DESCRIPTION NO, 12 BLOCK TR PLANS BUILDING S A.P.PPROVED .P. NO. BY DATE % YARDS EVES CFO I No. of BLDGB. SIZEOF LOT 60 x 104 Now LOT nope REQUIRED ALLOWED USE OF (CENTER LINE ST./1/ EXISTING BLDG. nnn> FRONT b D FT. IN. SETBACK LINE FROM W 60� I CENTER OF STREET REAR YARD R. SIDE FT. IN. L. SIDE ,S FT. IN. SIDE YARD ILEFT 51 (RIGHT rid DESCRIPTION OF WORK - REAR FT. IN. NEW I x I ALTERATION II ADDITION I REPAIR I I MOVING I DEMOLISH BUILDINGNO. OF 1560 SIZE ROOMS STORIES EXTERIOR W ROOF COVERING u (-` COVERING Rnek USESOFBUILDING AND WORK TO BE PERFORMED attached double garage. ,HEREBY I ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COM- THE AMOUNT SHOWN UNDER VALUATION I8 FOR THE PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. BUILDING CONSTRUCTION. VALUATION SIGNATURE OF PERMIT FEES 36,00 PERMITTEE PLAN CHECK S 18.00 AUTHORIZED AGENT Dike 8f, Oo1e T'OVe RC $15, 571 54.00 TOTAL FEE S Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA M////SA CO S/��TR/ UCTION,PER M IT P R IT NO.. - TRACT NO. LOT NO. UNIT NO. Project Address / t -.I) q CO "' h �K/ / �� ( 3q sc— I %oa Applicant's Mailin Address G-ryli TYPE OF CONSTRUCTION LJ NEW LJ ADD D ALTERATION U REPAIR �..� 6��p El CONVERSION 11 DEMOLISH ❑ OTHER A.P. # I3 Owner's Name PhoneOZ DESCRIPTION OF, WORK/USE OF BLDG. Address _ p Arch/Eng. License No. -�+�yl d .� TYPE OF PERMIT - ❑ GRADING FOUNDATION STRUCTURAL Address ^'('1 _ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL �C. �✓ 7 hone ffn2 �� ❑'OTHER Contractor's Nam - - Address (mailing) %�/ .? / - , f PROJECT DESCRIPTION SQ. FT. OCCUPA/N'CY�y—s, J CONSTRUCTION TYPE VALUATIONS City .License No. _ LICENSED CONTRACTOR DECLARATION I. hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full ford an yffect. ��si�� p Ll tens5 Class "--3 License No."' '97-3 Date Li^/— S Signatur . WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy the action 3800, Lab. C.)7J �Y 3� L / L Polley No. -%` Company. Q_Pertified copy is hereby furnishetlLIrCer?. rw��. p h the cit Daletl,yO PIsiRetl wiAl PPI cant✓ �l !L-/ �v�1 ti�+-*✓� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 1 certify that in the performance of the work for which this permit i5 issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the labor Code, you must forthwith comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for which is permit is Issued (Section 3097 Civ. C.) Lender's Name Lender's Address�/f�11'/fir OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair 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 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 therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their Sole compensation, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves ' thereon, and who tloes such work himself/herself or through his or her own employees, provided that such improvements,are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rprove for the purpose of Sale). ❑ I, a5 owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who cgntracts for such projects with -a can- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me.. ❑ [am exempt under'Section '' .B. & P. C. for this reason Date Owner ' -- information certify that I have read this application antl state that -the above Information is correct. 1 agree to comolv.with all clty and county ordinances ,upon Signature Drivers' License or SS 95- Remarks: u Bar Sink Backflow Preventer Backflow Irrigation GRADINGCU.YDS. A( Drinking Fountains 7loor Drains - Ploor Sinks Sas Service Outlets. Interceptors 1 Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Extaust System ❑ Multiple El Firepl/Fact,'Blt. ICBO # Heating System & Ducting ❑0100,000 BTU ❑ 10o,000 BT Reinspection Fee I $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING Showers --Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool vi/Spa Urinal -Water Closet - .Water Heater Water Service Auto -Wash Issue Fee Hood or Type 1' ❑ Canopy Type 11 ❑ Refrigeration System ❑0.100,0008TU 0100,000 System Repair/Alteration Fire Dampers Registers 3 Issue Fee FEES $ 3 F $ 3 S E T Front B Rear A C Right K S Left Ping. Ref. # Planning Notes: 00 i Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric F.A.U. 4694 6/11/83 Iilpll% 11. Zone Z / O � N I Parking Rt ELECTRICAL Transformer ❑ 15-50 KW ❑ 50_+ KW Meter ❑up to 100 amps Meter ❑over 100 amps _ Sub Panel Motors 00.1 HP❑1h-8 Inc.Solar ❑9-15 HP ❑16-15+ R' E 0 M T S Device Boxes Pole Light ' Outlets l Range Switches Sign Garbage Disposal ; Standing Sections Generator 00.5 KW 05-15 KW I Trash Compactor I I Reinspection Fee 1 $15 1 1 Issue Fee 1 $ 3 1 1 DEVELOPMENT SER Zoning Approved By_ Building Approved By 7_4 V 191.E SUMMARY OF FEES , s fi'+ BUILDING PERMIT $ 2.SQ SMTP $ PLAN CHECK $ PERMIT PLUMBING $ , (o -0Q ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ I Z CSC) GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ PLAN CHECK 25% $ ts74^. 7_4 V 191.E CONSTRUCTION AND PLANNING APPROVALS . Permit# •. Date Inspector POOL & SPA - APPROVALS Permit # Date Inspector. 1. Temporary Electrical Service or Pole' 52. Pool & Equipment Location (/ 2. Soil PipejUndrgrnd. 1 53. Steel Reinforcement 3. Iectrical'Conduit:Utility-Undrgrnd. 54. Forms - 4. Electrical Co nduit'Undrgrnd. 55. Electrical Bonding 5. Steol Reiriforcement ' - 56. Rough Plumbing & Pressure Test 6. Electricall UFER Grnd: 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. ' 8. Foundation - 1 59. Gas Pipe, N-U-nd_rgrnd., Test Ok- 9. Water Pipe-Undrgrnd. �j,• 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor Syste - 61. APPROVAL TO DECK 11. Property Sewer Line &•House Connection 62. Backwash & Receptor -Final 12. Sewer, Cap 63. Heater & Vent -Final 13. Roof Orain4' 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ElGas ED Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil • 25. Roof Sheathing - 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical t 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 -Filial - 40. Gas Service -Final 41. Solar Domestic -Final _ 42. Backflow Preyenter - - 43. Backflow Irrigation - 44. Landscabe Irrigation System 45. Sound Attenuation 46. Handicap Regulations ; 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed .. 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co I 51. CERTIFICATE OF OCCUPANCY No. Date 4- I-) PROJECT ADDRESS: 1609 BAKER ST UNIT' OWNER'S NAME: CAROROBERT N ADDRESS: CARO,, JUDY D 1609 BAKER ST COSTA MESA,CA 92626 JRCHIENGINEER: REG.NO.: A: ADDRESS: UNIT: PERMITTEE: BEST ROOFING (714)557-4040 ADDRESS: 765 ST CLAIR B COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby allhm that I am licensed under provisions of Chapter 9 (eommencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITyLIcl:0.s5�1718/ 6S1 I'D C-39 EXP: 09/95 Signature:_ RAERS'COMPENSATION DECLARATION: he al rm that have [ertilicale of consent to self -insure ora certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. La . C). POLICYNO.:1137512-94 EXP. DATE: 06/01/95 COMPANY: STATE FUND ❑ Certified copy is hereby furnished. ® Certified copy is filed 111 the tiOuildmg Division. at K �7I Applicant: XE ION FROMWORAERS' COMPENSATION DECLARATIO7is ed not be Completed if DN bermt a for one hundred (SlOR or less). euily that in the performance dl the work for which this Shall opt employ any person in any manner s0 es to become subject to the Wprkers' Compensation Laws of Californ Date: Signature: NOTICE: If. alter making this declaration, you should become subject 10 the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Cry. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby allum that I am exempt from the Contractors' State License Law for the following reason fSection 7031.5 Business and Professional Code: Any Pty of County which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires Rte applicant for such permit to tae a signed statement IM helshe M licensed pursuant to the provisions 01 the Contractors State License Law (Chapter 9 (Commencing with Section 70DO) of Division 3 of the Business and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penalty of not More than five hundred dollars ($500). I, as owner of the properly or my employees with wages as their sole Compensation, will do the work, and the ❑ structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his Or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the Owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the properly, am exclusively contracting with licensed contractors to Construct the project (Section 7044. Business ❑ and Professions Code: Tye Contractors' State License Law does not applyto an owner of pmpefry who bmlds or Improves thereon and who contracts for such projects with a Conlr2Ctor15) license pursuant to the Contradlomr Slate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: O. d P. C. for this reason'. Date: Owner: I do hereby county that I am aware of and understand the requirements of CaliforniaHealth and Safety Code Sections 25505. 25533. and 25534 and that I or any future building occupant well not (Circle one) need to Comply with said state codes and the requirements for a permit for construction or modification from the AIr ally Management District. Residential construction applications are exempt from these provisions. Date: Applicant:_ I hereby certify that I have read $his application and state that the ordinances and state laws relating to building Construction and herel property for inspection purpose$ Daat Signature: —6rrver's License or Social Security is correct. I agree to comply with all city and county mauves of this city to enter upon the above-mentioned 1641-46 White—Building; Green—Code Enforcement; CanaryApplicant: Pink—Revenue: Goldenrod—Assessor COMMENTS: SMOKE DETECTORS ARE REQUIRED xxxxxrtx�rx+rxxxxxxxxxxxxxxxxxxxxxxxxxx*xxxxxxxxTrxxxxxxxxxit*xxxxxx*xxxxxxxxxxxxxxx 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 BUILDING--------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ: PROV: PARCEL; 13919312 ZNE: REF NO; PLANNING NOTES> xxxxxxxxxxxxxirx,Exxxxxxxirxxx*x*x*xxxxxxxxxxxxxxxxxxrxrxxxxxxxxx+rxxxxx�_r.+rxxxxxx*x* D E V E L O P M E N T S E R V I C E S R E Q U I R E M E Ni S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE.- APPLICATION ATE:APPLICATION ISSUED BY: DATE;9 • L x xxxxxxxxxxxxxxxxxxxxx xxxxxxxxxx xx x xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE•n SMIP/RES GRADING PERMIT 54,00 ,50 SMIP/NON-RES PLAN CITY OF COSTA MESA - BUILDING PERMIT - PERM NO; B070896 PERMIT NO: B 070896 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE; OTH JOB DESCRIPTION ; REROOF OVER EXIST. COMP W/1 LAYER COMP SQ FT: 2,447 CLAIM VALUE: 2,447,00 CALL -VALUE: 2,447.00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS ARE REQUIRED xxxxxrtx�rx+rxxxxxxxxxxxxxxxxxxxxxxxxxx*xxxxxxxxTrxxxxxxxxxit*xxxxxx*xxxxxxxxxxxxxxx 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 BUILDING--------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ: PROV: PARCEL; 13919312 ZNE: REF NO; PLANNING NOTES> xxxxxxxxxxxxxirx,Exxxxxxxirxxx*x*x*xxxxxxxxxxxxxxxxxxrxrxxxxxxxxx+rxxxxx�_r.+rxxxxxx*x* D E V E L O P M E N T S E R V I C E S R E Q U I R E M E Ni S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE.- APPLICATION ATE:APPLICATION ISSUED BY: DATE;9 • L x xxxxxxxxxxxxxxxxxxxxx xxxxxxxxxx xx x xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE•n SMIP/RES GRADING PERMIT 54,00 ,50 SMIP/NON-RES PLAN - ISSUE FEE i BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 54,50 0.00 0,00 54,50 54.50 ,00 REVENUEDIVISION TOTALS--> COLLECTED: 54.50 OVER -/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 54,00 50 x xxxxxxxxxxxxxxxxfexxxxxifxxxxxxxffxxxxxxxxxxxxxxxxxxxkifxxxMxMxifxxxxx4xxxxxxxxxxxx I N D I V I D U A L F E E B R E A K D O W N � TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Q SFR 2447 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 2,447.00 END OF FEES LL f 01 00175,29-001756,30 Tri T 54.50 DATE: 01/26/95 T11ME: 12:04 C.. ,TR I,1',TION AND PLANNING APPROVALS Permit # Date Inspector P4vL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service•or Pole 52. Pool &Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 1,Electrical Conduit.UtilityUndigrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. "Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. B. 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 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 APPROVALS Permit 4#- 20. Rough Factory F(replace 21. 21. Ducts, in Structure- 70. Underground Hydro 22. Ducts, Ventilating 71. Product Pipigg CGas 001 23, Gas Pipe -Rough & Test 72. Underground Flush' 24. Roof Framing -' -73. Undergrnd: Storage Tank C 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 d 38. Final Plumbing i 39. Water Service -Final ' 40. Gas Service -Final r -• 41. Solar Domestic -Final 42. Backflow Preventer '- 43. Backflow Irrigation !._�Q -4 G �/�•� 44. Landscape Irrigation System . , - - 45. Sound Attenuation t• t -. 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ! 3f -cls 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OFOCCUPANCY No. Date �p Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAPE I NO TRACT NO. LOT NO. - BLDG. NO. 4154 4/05/92 17.00 CONSTRUCTION PERMIT cZ 2 O TYPE OFONSTRUCTION - ❑ NEW &ADD ❑ ALTERATION19 ❑ REPAIR ❑ CONVERSION ❑DEMOLISH - Project Address OWner hone Address - _ • - ❑ OTHER - DES9JRIPTION OF WORK 'ZONING REGULATIONS - A.P. 3 - — / - - • Arch/Eng. License No. Address - ZONE PLNG. REF. 9r ' Contractor - - Phone - TYPE OF PERMIT', - - " - s ❑GRADING ❑ FOUNDATION-•STRUCTU RAL-- ❑'TENANT'❑ ELECTRICAL ❑PLUMBING ❑MECHANIC - SET AC C V LINE. •1 1 •YARD------- - -- - - � SIDE V 6'5 Address - - LICENSED CONTRACTOR DECLARATION_ " I hereby affirm thLt I am licensed under provisions of Charter 9 (tom- prancing -wdh- section- 7000) of .Division 3 of the Business and , , ❑ OTHER.' RIGHT - - - Professions Code, and my license Is In full force and effect. ! REAR YARD (TOP /L) - PROJECT_ DESCRIPTION _ License Class License No. - - _ - - - SQ. FT: -' ` PKG. SPACE REQ. -PROVIDED. 'I 'Date - --"'" Signature - - - .-' - -' - - -- - - 'OCCUPANCY' CONSTRUCTION TYPE STREET WIDTH ,PARK FEES WORKERS' COMPENSATION.DEC LARATION to insure ZONING'APPROV ED BY DATE Z ' d hereby affirm that I have a certificate of consent sell ora VgLUATl01`T�la.dsl ZONE •rtlficate-of -Workers' Compensation Insurance. or a certifled'copy sreof (Section 3800, Lab. C.). GRADING CU YDS. ACRES -ESPECIAL CONDITIONS: t , Iticy No. -_- _Company - _ _ __ _ - '._ _ J._ _ _ _ _ ,❑ Certified copy is.hereby-furnished. . REMARKS: •_'L' _ _ /', ElCertified copy is'filed with the city Building Division. - _ _ _ _ _ _ _ - p -•� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - - -- - - _ -_ - - - - - - - - - `I� This section need not be completed if the permit is for One hundred '.. I q( ($100)or-less): _ .. .. _ s i 1 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 "PLUMBING - ,.,PLAN CHECK "�' '- - .ELECTRICAL - _ -PLAN CHECK- - subject to the Workers_ Compensation Laws of California.'UW1 BATHTUBS- SHOWERS-' - -' " ' - ' LLINU -90 FT Date Signalu re f NOTICE: If after making this declaration, you should become subject TOILETS if ,URINALS - -' - - - 'GENERATOR- - 01 KW_ 1.10 KW TRANSFORMER to the Workers' Compensation provisions Of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS----- , - -11 — APPLIANCE'- - 10-50-KW=50+KW revoked. _ _ I _ _ _ _ _ _- CONSTRUCTION LENDING AGENCY C - KIT. SINKS -' -' "-DISHWASHERS - - - MOTORS -- 0-1 HP_1-10 HP !I hereby affirm that there is a construction lending agency for the per. formance of the work for which this permit is issued (Section 3097 SERVICE SINKS" .SUMPS' - -- - - '(INC. SOLAR) _ _-30-50 HP 50 + HP- - FLOOR.SINKS-- - '-FLOOR'DRAINS- ,FIXTURES— - OUTLETS- -SWITCHESLender's 'Civ. C.I: -'- - "- - - -'f-'' - "' - _ '- Name Lender's Atltlresi - 'DRINKING FOUNTAINS' '- -' - GASTUBESIGNS- -'--•- -• - - - - INTERCEPTORS CLARIFIERS--•-- - rPOLE-LIGHTS- - --- - - - - - OWNER BUILDER DECLARATION- -- -' -- I hereb affirm that I am exempt from the Contractor's License Law for 7031.5 Code: SWIMMING POOL 'PTRAP- -• - - - - - POLES METERED SUB the following reason•(Section BusinessandProfessions Any city or county which requires a permit to construct, alter, Improve, demolish or repair any Structure, prior to Its Issuance, also re. WATER SERVICE' 'AL'TERATION -• •' -'-''PANELS-'- MAIN - SUB" ' quires the api ucanl for such permit to file a signed statement that he 'GAS SERVICE - '-OUTLETS SERVICE AMP --- Is Ilcensed pursuant -to the•provlfions of the Contractor's -License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the -WATERHEATERS BTU OUTPUT - - - - - ---- - - - - - uslness and professionsCode)or that hells exempt therefrom and the asls for the alleged exemption. Any violation of Soctlon 7031.5 by SEWER CONNECTIONS - - - - - _ - -- -'— -- - - - -- - - - -- - - any -applicant for a -permit -subjects -0he-applicant-to aslvll penalty- '.of not more than five hundred dollars ($500). SOLAR TANK - - -COLLECTORS - - t - - ---- -- - -- - - - - - -- '0 1'as owner of the -property, or my employees with wages as their Solo compensation, will d0 the work, and the structure is not intended or offered -for sale. (Section 7044, Business and'Professions Code: The- -SOLAR PIPING SYS: ISSUE FEE' - - - - •' - - - - - - Contractor's License Law does not apply to an owner of a property - _.. -ISSUE FEE "- - - -- -' - - - - - -- -APPLICATION APPROVED BY - DATE who builds or Improves thereon, and who does such work himself'Or- through his own, employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF,FEESIs Intended or offered for sale. If, however, the building or improvement have burden sold -within One year of completion, the owner will the of proving he-did-not'build or 'improve -for the 'Purpose-of"sale).- - "HEATING BUILDING--- --'- /6,00. �¢.�/I as. owner. -of. the properly, am -exclusively contracting with SYSTEM 0-100,00.0 BTU I AND DUCTING - - - - - - - PERMIT __S SMIP- E '� 4- AI CCn�Setl contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S � PERMIT and Professions. Code: The.Contractor's License-Lawdoesnot apply. to. .- _ ISSUANCE.-$'- _ an owner of property who builds or improves thereon, and who con. REFRIGERATION 0-100,000 BTU PLUMBING S}( n 'rads_fromsuch projects with a. contractor(s) Iicesned_pursuanl. to. SYSTEM - - - - --- - .. _ _GRADING'.. $ "PLAN the Contractor's License Law). 100,000+BTU CHECK $ - ❑ I am exempt -under Section - - Bt& -P. C. for this- - - - - - BOILERS BTU ,ELECTRICAL $- - -- $ reason _ __ _ _ - _ _- SYSTEM REPAIR, ALTERATION - EXHAUST SYSTEM MULTIPLE _ MICROFILM $ - PLAN CHECK- $ - - - - MECHANICAL•.$ - TOTAL FEE $ _ ( LESS AD.-i • PLAN CHECK- Date Owner 1 hereby certify that I have read this application and stale that the above -all -and city comply- inlorma(lon is correct I agree' to with county - ¢ _ VANCE PC-'$ _ - - ordinances and state laws relating to construction, and hereby authorize- r¢pr¢sentative5 this city- t enter -upon the above en toned ( property for ection per o s. �~ Signature -- 9�6_ _ _ L Oate 1_ FINAL FEE $ - odvers"EiCehSeor 5 # - ISSUEFEE _. _.___._ _. _ ___ - -_ _ _ -.. --'-` -- CMF 0865-46h(WhitkBuiloing� Cana ry-App' Pink- eco ting; Goldenrod -Assessor CONSTRUCTION AND PLANN` IG APPROVALS - Permit # .S�' LL(L ` Date Inspector ',� POOL &SPA _ Date APPROVALS. Permit # ... inspector 1. _ Temporary Electrical Service or Pole _ 43. Pool & Equipment Location 2. SoilPipe-Un rgm - _ 44. Steel Reinforcement 3.. Electrical Conduit UtilityoUndrgrn. .45. Forms 1. - - -4. Electrical Conduit-Undrgrn 46.. Electrical. Bonding - - - 5. Steel Reinforce _ -�,Z _�'Z 47- Rough Plumbing & Pressure Test - - 6. Electrical UFER Grn _ - 48. APPROVAL TO COVER-GUNITE - 7. _ Footings _ _ - 49- Electrical Conduit-Undr rn - - 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test" 9..- Water Pipe-Undrgrn _ 51. Backwash Lines P -Trap❑ Undrarn 10.. Structural Floor System .e _ .52. APPROVAL TO DECK - - - - I1. _P.roperty Sewer'Line &House Connection 53-• Backwash & Receptor -Final 12.- Street Sewer Connection - - 54. Heater & Vent -Final 13. Rough Plumbing _ - - - - 14. Rough Electric -Conduit - 56. Electricat-Final ' 15. Rough Electric -Wiring - ' - .57. Solar System -Final - - 16. - Rough Heating & Air Conditioning _-ZE17-Fencing & Access Approval. 17. Ducts in Structure- _ _ APPROVED FOR PLASTERING - - 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test a- - - Roof Framing - - - - --- 60._ POOL/SPA SYSTEMS FINAL - 21. 22: Roof Sheathing Frame and Flashing NOTES:` ' 23. Insulation 24. -Lathing & Siding - -- -- - - - - -- - - - ` 25: Drywall Nailing 26. Plaster Brown Coat - - - - - 27. Electrical -Power Meter -Final - - - s • - 28. - Final Electric - - - - - - 29. - Final Heating & Air Conditioning- - - - - - _- - - - 30. Final Gas Pipe -Test - - - •- 31. Final Plumbing 32. Water Service -Final - - - - - - - 33. " Gas Service -Final - 34. Solar Domestic -Final ' • _ 35. Landscape Sprinkling S stem 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE&BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY - No. Date --