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Home My WebLink About1924 HARBOR BLVD - Building Permits 4b. 1fr - CITY OF COSTA MESA F v__ ,I BUILDING DIVISION PERMIT NUMBER DEVELOPMENT SERVICES DEPARTMENT PERMIT SB99-00048 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 • SIGN PERMIT • Job Address: 1924 HARBOR BL Status: ISSUED Suite: Applied: 04/15/1999 Vicinity: Issued: 04/15/1999 • Parcel Nunmber: 41920511 Zoning: • ISSUED BY: Applicant: BEATTY, FRED Address: Phone: (714)373-1375 Zip: Owner: RUFFELL, DAVID A TR Address 307 E BAY FRONT Phone: BALBOA ISLAND,CA Zip: 92662 Contractor BLAKE SIGN COMPANY INCORP Address: 15661 PRODUCER LANE Phone: (714)891-5682 HUNTINGTON BCH,CA Zip: 92649 License: 506422 Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT REMOVE 3'X24'WALL SIGN AND INSTALL 2 WALL MOUNTED BLANK FACED ILLUMINATED SIGNS (31X10'). Ems_po 30cia FEE SUMMARY Plan Check: $27.95 Calc Valuation: $1,300.00 $0.00 • Permit: $43.00 Claimed Valuation: $1,300.00 SMIP Com: $0.50 • Other $0.00 $0.00 • Inspection: $0.00 $0.00 $0.00 Total: $71.45 PLANNING & ZONING NOTES: r 9 *. (TUFA A OOP 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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. 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. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS f l WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I 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 Mm 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 carrier and policy number are: Carrier: C46U/E-3.3 I AI W ItSS Policy Number: -NuJt.- Aigo Z5�Q_s (This section need not be completed If the permit is valued et one hundred dollars($100)or less.) ❑ 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 workers' compensation laws of C la,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 pr sions. [2 Applicant Signature: Date: 4. (S R �1 WARNING:FAILURE TO SECURE WORKERS'COMP SATION COV GE UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($106,000),IN ADDmON TO THE COST OF COMPE s TION,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 ro sions 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.Lic.s � . Class a C 8r Contractors Signature: G—)r-. . S cjcs -- Date: 4. l`Scite CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there Ls a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI 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).): ❑ 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,Contraclors 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 a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 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: ❑ I hereby certify that no excavation Ilve(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. 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? 0 Yes 0 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? 0 Yes 0 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 Safely 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? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application&Lermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ 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? 0 Yes 0 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? 0 Yes 0 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 end city ordinances regarding Hazardous Materials and Emissions. Signature:.•— • Date: CERTIFICATE OF COMPLIANCE ANDrAUTrybRQATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct.I adree 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-descdbdb property for Inspectigripurposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. Cr4)J Signature• e!al Ow er(s) Date And/Or•uthorixed A..'Can Date CODE 0 INSPECTION WPC 2ATE INImd4,4 CODFf INSPECTOR TYPE PAIS INirTIAI& 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing • • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall ., 212 Final Flre Prevention • 202 Final Factory Fire Place 220 Final Planning Approval 203 F fort - C 2222 Final Site 204 Inion - - ,603 ; Final Building/Occupancy 2446-46 W �rJ�3c•. CITY OF COSTA MESA , �''%. BUILDING DIVISION f' ' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT E99-00306 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1924 HARBOR BL Status: ISSUED Suite No Applied: 04/15/1999 Vicinity: FRONT ELEVATION Issued: 04/15/1999 Parcel Nunmber: 41920511 pp ' ISSUED BY: *Ill Applicant: BEATTY, FRED Address: , • Phone: (714)373-1375 Zip: Owner: RUFFELL, DAVID A TR Address 307 E BAY FRONT Phone: • BALBOA ISLAND,CA Zip: 92662 Contractor BLAKE SIGN COMPANY INCORP Address: 15661 PRODUCER LANE Phone: (714)891-5682 • HUNTINGTON BCH,CA Zip: 92649 • License: 506422 SCOPE OF PERMIT REMOVE 3'X24'WALL SIGN AND INSTALL 2 WALL MOUNTED BLANK FACED ILLUMINATED SIGNS (3'X10').SB99-00048. • FEE SUMMARY Quantity Quantity ISSUE FEE $22.00 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 - Misc Electrical Equipment $0.00 0 New Res(3r-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 . Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp . $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $44.00 2 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $66.00 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS i r NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremet Ili d i • la statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. 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 end final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS Cl WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Cade,for the performance of the work for which this permit is Issued. I have and wW 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 carrier and policy number are: Carrier: (f)W Ga C9'CC t IJ S Policy Number: L 1(. "i 1 L(4ZS O2' (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ 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 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 provia ^�,�L — f Applicant Signature: t_m Oe�a� Date: 4. 1 s ,R FAILURE TO SECURE WORKERS'COMPENSATION CO IS UNLAWFUL AND SHALL SUBJECT MI EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND CODARE(S1%,ODO),IN ADDfRON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 31080E THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under•rovi ions 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.Lie.p - Class N Gf{5 Contractors Signature: �=`�7/1 ' r' Date: 4:4 ){ CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lenders Name: Lenders Address: Signature: Date: • • OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that 1 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'puauant to the provisions of the Contractors license Law(Chapter 9(commenting 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).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,end 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 a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 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: ❑ I hereby certify that no excavation fwe(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. Signature: Date: Division of industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I 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? 0 Yes 0 No (Section 25505 of the Califomia 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? 0 Yes 0 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 end 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? D Yes LJ No (Section 85850.2 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? 0 Yes 0 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? 0 Yes 0 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: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. a C/ -.Jr I. atilt Of ega • ner(s) p Date ` �•� r,� 'r(/ -Sl- s 4-4 tc.9S 'L Andhr Authdtlz:•App Ica Date p00E t INSPECTOHTTPfi4Fae,, DEE MEM CODE! INSPECTIONTYPE D,IE MEMO 1616 Fixed System Final Fire Prevention' 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing • 200 Final Re-Roof 210 Final Electrical ?I-Who V 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 244846 ADDRE530PBUILOPc 1924 HARBOR BL WIT: .. CITY OF COSTA' MESA - BUILDING PERMIT GJntRsNAYEYIDaImRUFFELL, DAVID A TR PERM NO: E 082153 ADDREss:307 E BAY FRONT BALBOA ISLAND,CA 92662 PERMIT NO: E 082153 PLAN CHECK NO: N GOVT: N SUPP : N APPL.MAILING ADORES& CONSTRUCTION TYPE; V- ! • IT TYPE; ELE PURPOSE: OTH ARCHITECT OR ENGINEER: UG NO.: JOB DESCRIPTION : NEW SERVICE METER SQ FT; ARCM OR EMI ADDRESS: WIT: CLAIM VALUE: CALC- 7' UE: GROUP OCC: M / CONITIACTOWS NAVE wwSuCOMMENTS : METER ONLY CONIRACTOR4 MAILING *********lf*****************fFlElf**********iEltlf# *** fE#*1t1E1EfE#iFiE'A"1ElElEfE****iE1E*****M* AXRES& MHO.: gMT, ZONING REQUI MENTS UCENSED CONTRACTORS DECLARATION:I hereby afam under penely of pedury that I am licensed under provisions of Chapter S S E T B A C K (commencing with Section 7000)of Division 3 d the Business and Pmlesa'vu Code.and my license is in hu lace and effect. CITY LIC.NO.: UC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR : FT IN FRNT: FT IN REAR: FT IN Date: Contractor LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby elfum under pend/of penury that I am exempt from the Contractors lite Law for the Code:reason PARKING REQ' PROV: PARCEL: 41920511 ZNE: REF NO: demolish.or repair any structure,pion b 4s issuance,also requires the applicant for such permit to file statement signed sernent that he or she PLANNING NOTES> is tired pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Cade)Cf hal he or she is exempt therefrom and the basis for the aged arnpion.My violation of Section > u 7031.5 by any appkaal for a numb subjects the applicant toe def penally d mat mon than five hundred doges;IS5003. It ft Rt it dE*k 1t it 1t it k ff it Rt eft 11*Rt*it eft*it 1t 1t♦E 1t irk eft it iE*eft it eft eft ft 4 eft Rt it dF 1E eft ft****it**eft it iE eft*>E eft*1t it♦E**ft tt#!t Rt eft It**Nt*tf ❑ I.as owner of the properly ormyemployees wilhwages astheisole compensation,will dothe work.end the stricture is not intended DEVELOPMENT SERVICES R EQUIREMENTS or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not appy to an Owner of progeny who builds or improves thereon,end who does such work himself or herself or through In or her own employees.provided that such . - inpsovemerfs are ra landed a Stared for sale.It.however,the bui)ing or impovemrd is sold within ore year of completion.the ZONING APPROVED BY . - - DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of ab). ❑ I,as owner of the property,are axdusivey contracting with licensed contractors to coming the project(Section 7044.Business nod BUILDING APPROVED BY : : DATE: Professions Code:The Contractors License Law does not apply to an owner of properly who builds a improves thereon and ye n contracts for such projects with a contrmods)licensed pursuant to the Contractors License Law). / C� ■ • exempt under swbtaP7044 B.AP.C., his OWNE ING RK APPLICATION ISSUED BY : - / C DATE: ^e' ° ne **dt�t�tdtdc�t t*stRtktiEifiE1(RtRfRt**itytttifLftFiE+tfERtRf*dtRtit It ***40********************aA+F *itttit stint** � LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N cant/that I am aware d and understand the requirements of California &dew Section 25505,Paco,.and and thanora/ Sura building occupant will not(circle barns/cells said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING i for construction or modificationfrom theAn Duly Management District.Residential conanciian apptcelions are exempt from tae PERMIT 27 25 provision. Den: Applicant: PLAN SMIP/NON-RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dederatiro: ISSUE FEE 22 . 00 ❑ !have and will maintain acenfwedconsent tose44rm.ebrworkers'canpenatbn,esMoaedfor bySaction3700dtheLeba BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code.for the p°d" " moeeltleworkfowhchthispernabissed. TOTALS----> 27 , 25 22 . 00 0 . 00 49 . 25 49 . 25 . 00 ❑ I have and wit maintain wortsrs'compensation insurance,a required by Section 3700 d the Labor Code,kr the performance of the work this pest"e" workers' aped'My oam°enaetomwmune n ran`e ni end poky number ore. REVENUE DIVISION TOTALS--> COLLECTED; 49 . 25 OVER/SHORT: . 00 Canter: Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need nor be completed)the sienna is for one hundred dollars pingo,lam) 49 . 25 ❑ I cony alta in the performance of the work for which this permit is Sued,I shall not employ any person it any mance so a to becorna subject to the ea s'amursaiam laws d Catania and agree the d I daub become subject to the waken' *****************lf**lt********************if*ff********ft*****Tilt#******#*#********* compensation pnwtaixes dw Sad n 3700 the Labor Code.I mall forthwith comp&with nose pwtalan. INDIVIDUAL F E E BR EAKDOWN Data: Applicant: Warning:Failure to secure worts&compensation coverage la unlawful,and shall reject an employer to admiral penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($004O00).hi addition to the cwt of compensation damages a provided for In SecUan3706ofthe Labor Cods interest and afOma'afees ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 27 , 25 27 , 25 CONSTRUCTION LENDING AGENCY:I hereby elfin under penalty d perjury that then is a condntlion bMmg agency for to END OF FEES performance d the work for which this pens I issued(Section 3097.Cb.C). LENDER'S NAME: LENDER'S ADDRESS: I candy that I have reed this application and atate that the above Idormation is coned.I ague to comply with all ray and candy ordinances arid state lea relating to buidiq construction and hereby authorize representatives of this ply to enter upon the shore-mentioned property for m'°°°on PurPmesp AV ID RU• FELL 83-24-1997/81:87 PM/$49.25 55 ' / PERMIT:082153 Pd -L t c Date: J^ �� /Signe -,enVApplican t• tractor / (5151.46WP) Whue-Buildi g A Safety:Gran-Rte:Canary-Applcant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING PO I SPA Date Inspector . Date Inspector APPROVALS Permit# - APPROVALS Permit # " 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 & Pressure Test - E.'Electrical UFER Grnd. • - -57., APPROVAL TO COVER•GUNITE- 7, Footings 58. Electrical Conduit-Undrgrnd, 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test - 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. ' 90. 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 _ -- r 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 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 '1. -.faster Brown Loa 79, FINAL INSPECTION 32, Electrical Power Meter-Final 2% O FOOD CERTIFICATE ISSUED 33. Final Electric " '� '_-1, Notes: - 34. Final Heating& Air Conditioning - • 35. Final Gas Pipe-Test• - 36. Hood or Canopy - 37, Final Fact ry 38. Final Plu ing , 39. Water r/vice-Fine/. 40. Gas Setice-Fina , 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. FINAL PLANNING • - 49. Electric Release to Edison • .. 50. Gas Release to Southern California Gas Co - • , 51. CERTIFICATE OF OCCUPANCY No Date