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Home My WebLink About1936 HARBOR BLVD - Building Permits Costa Mesa Building Department o PLICATION'FOR PERMIT - „t 111 EAST 20th STREET Oovv`` BUILDING1 COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN FOR OFFICE USES / ONLY /��NV 'T 1 Permit No. BullringJ9 ? 4 1 / n d Address �/ !T �t'� Costa Mesa, California Received by Dat Recd. Date Issued Nearest ,� p I /-02 6 -Sr Cross SL j'"rv.Ot.r ,,/ Building Address Owner a'�f' , )j .„-..,"-..---4---; Costa Mesa, California Mail h Address j7! `J 2t-r4 a-r.4 a- . ( Nearest ,�,, yy Tel. , Cross St. City t4 12—° 4r-A-)--41 No.`/t•1n} e Zone I No.of I Type I Group Architect or Lic. Plans Engineer /�!� No. Approved by Date rens " CORRECTIONS n c City Lie.Contractor a.-er- iti1-n..aa-e) No. Address Legal Lot Description I No. I Block ITract (Attach Metes and Bounds)//S - aAt 7 - y yr. ;L0 ,"/odNo.of Bldgs. Size of Lot Lott X_)IC I Now on Lot 0 Use ofNo.of No.of A Existing Bldg. e..4:1-11 ..41P-4111--1 Families I Rooms G1 Setback Line from Rear Yard _ 1 Center of Street Side Yard D DESCRIPTION OF WORKTot:SAI �' New 1--H I Alteration I I Addition I v P, Repair I I Moving I I Demolish I , - ^' 2 6 1s " y( Building No.of .3k ;17000iii,,,��' Rooms Stories ��1► • :dor Wall Roof !1 .,..vering I Covering II ,i' .I'. Use of New f ��Arty Building Cert.-d V Foundation L Forms,Mau((((((�� ls, Inspector Date Under.Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath.Ext. with all City Ordinances and State Laws regulating building construction. Signature of _ Plaster,Int. Permittee //� /f•4"" /(�tvt-LLr (/ Plaster, Ext. Authorized Agt. Masonry Reinforced Valuation Permit Fee $ Plan Check $ �� 0 49 Bond Beam $ /c`° • `� Total ..S`O —.. ..,.. fl-u 'u n.na Fee $ / S 0 FINAL 0 C 00 ci. 0. , r Street al P , ; h• I, • r. 3" t PLOMPLAW Show location and disianCes from r- 1., . .1 propertylinc'and between buildings. 4 c— 1 / t'n• • r; 7- - . - • - • _ - -— 1 ' 1_ ; - 5391 vsm MOO JO !10 ; Tfa ,n,2 14 SA BUILDING DEPARTMENT 14130 3�Nb'Nlj p,O.BOX 317 /i b it l ' OSTA MESA. CALIFORNIA ((�1L o FOR APPLICANT TO FILL IN APP6.JJMARMIT BUILDING DRESS i 9 J�4 2 BUILDING AD COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY //77O /�� // � RECEIPT NO. P$PMIT NO. OWNER `Bb oC VVI. `O. J i5/7MAIL 9 �r RECEIVED BYDATE RECEI'V'ED' DATE ISS_UE1D ' ADDRESS I Ol CO '� I V ... ...71.1.7a"" &<t-y / 7 3 V /7 nhum Aa A TEL. BUILDING CITY \V /`p NO.LADDRESS ORC NEER gr, Q4 R1d'(�(��.,,, NlO..�6 Z 3 COSTA MESA. CALIFORNIA A ODRESSIagi.I CI izou- SIL Wing FIRE ZONE d + T V utc1 Tiu4 CITY LIC. 6s--6, / ZONEd... /T PLO.NS PE GROUP `/ ADDRESS a L n., r< n50 CT, 1 ,<TTEDcL. i:3E%. APPROVED F� NBY DATE LEGAL LOT NO. ,��10c CORRECTIONS DESCRIPTION NO. /� GBLOCCK7 !dig T A.P. NO. /Art'' 2-• rl O'- V y . - • VE �/ / 0�\ NOW BLOCS. I I , / nu V Y OF LOT 9 y x l o V NOW ON LOT �� I' .�, x * }� IA x USE OF EXISTING BLDG. Jets .5wTA•) rT-TY I COSTA MESA SETBACK LINE FROM ' , CENTER OF STREET �C< . - REAR YARD 13 .�/ PLA KING DEPT. ` 4V t\ SUtlJCW �U BLDG. DEPT. REG. SIDE YARD RAGHL 1 Ci ( LEFT � llgTE� / / /l DESCRIPTION OF WORK I \ BYAA3 /�A _ _ \ PLAA�ANN TcCH. NEV ALTERATION ADDITION .Q `\ REPAIR - MOVING DEMOLISH SUILDINGA 4%.} ROOMSA STORIES X ,1,��t SIZEUIM Tr 1C_ ITS EXTERIOR WALLi ROOF PP COVERING � `. COVERING JR- A < USE OF NEW A BUILDING \ ,. -SC.... �� IJV N^{ 1-C,�J • ., I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC• TION. VALUATION ,<,1 O O SIGNATURE j�ir r• Opl_.�y / PERMIT FEE 5 VA{ PERMITTEE < %vim{ F-JrDDr t-�1` l✓ omC v �� d PLAN CHECK $ /�, G L TOTAL FEE $ S� S^°vB�T AUTHORIZED AGENT S `,.._ ,4 ti BUILD DEPARTMENT N Street l�° 217 t .„-- ' California �.'. Date i/ ,' _ 7 1 CITY OF COSTA MESA CERTIFICATE OF OCCUPANCY Building Permit No`•I'/ /"Electrical Permit Ne'' f i • Plumbing Permit No /1/ r h leikU r' ----e-c_ V"/1Cc... -574i Use of Building..._ f,"'Ak • k !r j,_......_.._._ /7'The building_locateed at. ` `. - �� V�� ''N1A AfEriH _ CAi, 7!• 4,r. 7 -e,,r;r _ i ,i Lot Block Tract (See reverse side for Metes and Bounds) has been inspected and found to comply ph the provisions of all City of Costa Mesa Or- dinances applicableicthereto for a Group r - f Occupancy. ///4 rED TO;/ '/ A.J.NOLZ / [� �� // �C City B Ildin ,O lal ` '� /� 9 (Owner of Building) BY Li -r J t,!i�j l V CC: 0 Original—Owner Q 1st copy—Gas Co. Q 2nd copy—Edison Cof ❑3rd copy—File Form 206 C-H 1M 12-55 ^ - t d OWNER GOODE OIL COMPANY DATE 9_jl_Kp JOB ADDRESS 1 936 Harbor Blvd. BUILDING PERMIT NO. 5651 S'sENNo.UUEEAbCONTRACTOR Sian Hangers, Inc. VALUE $ 1,200.00 11 AP. LOT TRACT FIRE ZONE DESCRIPTION OP WORK Sign C^OUP TYPE ZONE PLAN NO. 5525 l .aPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing Lathing, hi Out Plaster, brown coat Underground soil W/G Pipe Test Top Out _ Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating Final bing Fixtures, Final . .` +. Gas Test Construction Pole Underground Power Rough Wiring /0.)— ct /1../P, t- .:;.-v r 1-A/-3-7 .3-1,77Fixtures, Final (/ - A OCCUPANCY .0I.rh /D- 5`-1 5651 Form 210-5M—I-57 Costa Mesa Building Department 9 APPLICATION FOR PERMIT f 111 EAST 20th STREET COSTA MESA, CALIFORNIA _ ___B U 111.1)..1 NG___ _ '11 ! FOR OFFICE IJSE ONLY I > FOR APPLICANT TO FILL IN Receipt No. Permit;No. ; Building jzp /7 y�y//!� /� /, ' Address k719/214,e.„4„02.-.C--/- "'`�{v�-s y� I Received-by. Date Reed. Date Issued `. Costa Mesa, California ; Nearest I n -) - 3 -.��5 ' Cross St � i,,�� '' Building I .../e .CG!� L Address OwnMailer�u..cco � _ �y �+ // Costa Mesa, California � Address 793, -- /t<er-- let—/"?yai.cf Nearest I i I Tel. ` Cross St. ' City (Pas-472 :;4,1.44" > No. Zone0 9 I No.of I Type I Group `-}" Architect or Lic. l - Plans I ! ,/ Engineer No. Approved 1 by Date ldress C' Li_ �r CORRECTIONS i contractor CSG eX dr Address 7,61-f.:14. - . �z Legal L ' . Description I No. I Block I Tract (Attach Metes and Bounds)Ais an �� t ® e No.of Bldgs. I Size of Lot yynz � /00I Now on Lot __..... - - p Use of I No.of • I No.of I -- .-_•tip 9 Existing Bldg. Families Rooms „,. p p 1pC O Setback Line from Rear Yard -- -- -• - -;-�;2-3"1955 _... •_ _ 'Z Center of Street Side Yard y DESCRIPTION OF WORK ..,, .- 4'. •" `" r New I I Alteration I I Addition I CITY OF COSTA MESA: Repair I I Moving I I Demolish I Building No.of :ze Rooms Stories tenor Wall I Roof ..cvering Covering APPROVALS Use of New Foundation Location Inspector Date Building __ Forms,Materials, Sp/.gyp 4. - G( 31 Under-Pinning . ,,/J. - _ Frame: Fire Stops, Bracing, Bolts .,. 1.. " Q'?t'/ '• ,,mac. • 2 �ca . I hereby acknowle c that I have fad this Application Lath. Int. and state that the above is correct and agree to comply• Lath. Ext. ' with all City 0 •inances and State :ws regulating building constr tion. •— Signature of 1 A' ea Plaster, Int. Permittee _ 1 44 �. / Plaster, Ext Authorized Agt. '4: G� - Masonry Reinforced - .o Valuation Permit Fee $ .."-CC) � 1, Plan Check $ /•. C O Bond Beam $ 16 ---- 5 g Total Fee $ /, D O FINAL / Form 201 Cif IM 12-53 O C o 1 � .. . a. J G a. E a. Street PLOT PLAN Show location and distances from 1J .. . property line and between buildings. • CITY OF COSTA MESA • a �'''4= BUILDING DIVISION . ., :�� a. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.G.costa•mesa.ca.us t. i- J.f� FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBER: B09-00025 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 41920516 _ DATE ISSUED: 02/02/2009 • - - `- .ISSUEDBY: KJB JOB ADDRESS: 1932 HARBOR.BLtM `"Suite/Unit:': Vicinity: . Squares: 3000 Valuation: . •,$15,000.00 y1 SCOPE OF WORK: TEAR OFF EXISTING BUILT=UP ROOFING.REPLACE WITH SAME. FLAT ROOF.CLASS A ROOFING MATERIAL. APPROX 3000 SQ FT.COMMERCIAL BUILDING:CERTIFICATION OF COOL ROOF MATERIAL WILL BE PROVIDED AT INSPECTION. • OWNER: HERBERTS,CURTIS A •. ' - • " . Address:` ` 2290 CHANNEL RD '' Unit PHONE: ftx ▪ _City/State/Zip: BALBOA,CA APPLICANT: NEWPORTrROOFING INC'i ' Address: 177 RIVERSIDE AV - t. '_ Unit: r PHONE: 949-645-0104 ,:;-- :Wr City/State/Zip: NEWPORT BEACH,CA w ,.,i CONTRACTOR: NEWPORT ROOFING INC • `r.' ' -- License No. 5244.54 Address: 177 RIVERSIDE AVUnIt: '' - - PHONE: . 949-645-0104 City/State/Zip: NEWPORT BEACH CA -92663 r _L CELL:. I , . ARCHITECT: ,Sq., , , ,2i License No. PHONE:„ , _ r ENGINEER: - License No. . ' , PHONE: • it , FEE SUMMARY Reroof Plan Check: $0 00 Reroof Permit Fee: $251:25 - ", ----- ' -._ - , Reinspection Fee: $0.00 ,.-. ` , :'r,' ,1• ' Bldg Std Admin Fund $1.00 ' " TOTAL FEES $252.25 • ' S 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. MQQ(J, INSPECTION TYPE Qom. [EMU ME( INSPECTION TYPE, On INOWIAL5 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof z_i 1/OQI t444ANI 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: Owner ID verified by drive se. ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. O I have and will maintain workers'compensation insurance,as required by DIVISION OF• INDUSTRIAL SAFETY PERMIT CERTIFICATION: 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 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: cAt ,r�� / person is required to descend,will be made in connection with work authorized s i 6 by this permit,and that no building structure,scaffolding,falsework,a demolition (This seem need not be completed dtne perm a.alued at one hundred EWars($t00)a less) or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.341,Ttle 8,California Administrative Code). P YLNnmber—a- 2 I y— Zoog' ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the wo ers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I sh with comply with these provisio 2- /i Division of Industrial Safety Permit Number: Z �-JJ/i�l tgnalure morf HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES, 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 UCENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. /.. a registration form for acutely hazardous materials? 0 Yes ❑ No Lap L .Lot:Lot ::-_-.C.:" (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by Ar/JT L 0 each business which at any one time has on hand a quantity of acutely •• s ignaw-- $a.41.- - 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which tfus permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No Lender's Address: (Section 25534 of the California Health and Safety Code provides that the • Costa Mesa Fire Department may require the preparation, certification and - :tfiling with the Fire Department of an RMPP by businesses which are required ---- r to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: m Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM:WHE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No 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 (Section 65850.2 of the Califomia Government Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division1J of the information be furnished on applications faran-residential building permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If. however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and p p rty, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. roe ❑ I, as owner of the UCENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Dale - property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractors)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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 er(s) Dale Signature Date 3057-46(3/07) �� 2-,/2 09 '/f/ - - • Applicant to fill in all spaces except those within heavy border lines antl sign all appropriate declarations. - _ \" CITY OF COSTA MESA C TIO _PERMIT PERMIT- /� NO. TRACT-�NO. LOT NO. UNIT NO. 7099 5/01/67 13055 TL - Project Address ft Z�/� i7r/nc�C_ A 2-1?-5/ 2 I rrs{y('/y . Applicant's Mailing Address TYPE OF CONSTRUCTION U NEW ❑ ADD ALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OT ER ,sem., q,p,�6 /'/./l - 2,0c_ /0 I Zone G' Owner's Name a-? lei. S.tA Ph e.�i3/-/lEro -ft •L(t"+-v mitf1/.y qe�j 44/ DE CRIPTIO •F W•- /US O�F B1,� Address 410t.` �� 4' ' "•`T• [/1 i J r GM/� _.to S Main Building: Accessory Building: Arch/Eng. �0 /a/i/ 1"- License No. TYPE OF PERMIT . GRADING . FOUNDATION STRUCTURAL T FrontZ y� 0 Address J_ — ,rr Asn'/, r ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam / ❑ OTHER I Quer SJh 5l y 5 h, PhoneC / -3d40 6 C Right N Address(mailing) $• o rI�5 `^-ri !Je»(-A rhPj PROJECT DESCRIPTION 5p. FT. /� OCCUPANCY �� K :..................- ----------7 G City License No. •-}St�� CONSTRUCTION TYPE v- /V VALUATION$ 75� $ LR ZONE — GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION _ Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Pe.4 22?,�'7S Planning Notes: � j'i �ry� M withisection 7000) of Division 3 of the Business and Professions Code, and U ' 7-C1 ' my license is in full force and effect. T License Class 66 Lisgpnse No ?',0 7c C.. _ $ n Date 'Cl/IY') Signature ��,e`L PLUMBING FEES S YORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL • FEES tereby affirm that I have a certificate of consent to self-Insure or a certificate - ..f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink -3800, Lab. C.) Automatic Washer Transformer 0 15-50KW _\ Policy No. 12_4../C jr a'j 3i?a/company C e.;-"e c_V Backflow Irrigation Sewer Cap - Construction Pole Sub. 0 50+KW \V 8Certified copy is hereby furnished. s CertitieP Copy is filed with the city ding Division. Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps 1 Date S_'' `- 7 Applicant L K rce/f ec - . 1 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher , Mi: _ over1O0amP.....__, r• (This section need not be completed if the permit is for one hundred ($100) or less). - Dishwasher Solar Piping Dryers ❑Gas ❑Electric SPanel 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 Mrs HP ❑l%-8 Workers' Compensation Laws of California. - Date Signature Floor Drains Swimming Pool w/ -a F.A.U. I olar ❑9-15 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 revoked. — CONSTRUCTION LENDING AGENCY Gas Service Outlets Water •set 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 er Heater Outlets Range Lender's Name - g ' Lender's Address - Kitchen Sink - • Water Service Switches Sign OWNER BUILDER DECLARATION - I hereby affirm that:I am exempt from the Contractor's License Law for the Lavatories Auto-Wash ' Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or • county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit Generator 00-5 KW 05-15 KW Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains 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 herefrom 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 Reinspection Fee $15 Issue Fee • compensation, will do the work, and the structure Is not intended or offered Reinspection Fee I S15 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 '❑ 441/8�- sale. If, however, the building or improvement is sold within one year of com- • Canopy Type II 0 Zoning Approved By • �/��C�sq�/��_f_ Date pletion, the.owner will have the burden of proving he/she did not build or lm- Duct-Under Ground _ Building Approved By - s�C+l Dated/11�r I f orove for the purpose of sale). (, I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural • Refrigeration System Application Issued BygE1 Date S/i/p 7 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 00.100,000 BTU ❑100,000 BTU SUNJMARV OF FEES builds or Improves thereon,and who contracts for such projects with a con- (9 • 5-3 tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System pair/Alteration BUILDING PERMIT $ SMIP $ Proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ • z� PERMIT. 0 i am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# F' e Dampers PLUMBING $ ISSUANCE $ Date Owner - Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that i have read this application and state that the above 00.100,000 BTU 0100,0008 ELECTRICAL $ GRADING $ information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this city t enter y�P on the above-mentioned property for • rge inspection p,4 � TJ /` ' Drivers' License or SS - MECHANICAL $ TOTAL FEE $ //3- Signature # �� / Issue -L- ReinspectionFee $15 Fee $ 3 PLAN CHECK 25% $ ' CMF 0865-46,rev. 10/84 White - 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 & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O 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 71 67. Fencing & Access Approval 17. Rough Wiring Sign H1 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling /f `�� 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Ai�r`7Eo 1d loninif! %/ FIRE DEPT. REQUIREMENT 20. Rough-Factory Fireplace --44� Mfr APPROVALS Permit# - • 21. Ducts, in Structure -. air 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 ' 31. Plaster Brown Coat 79. FINAL INSPECTIONI • 32. Electrical.Power Meter-Final 80. FOOD CERTIFICATE ISSUED +I 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-Final . 40. Gas Service-Final 41. Solar Domestic-Final • • 42. Backflow Preventer - - - 43. Backflow Irrigation r 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations i 47. FINAL STRUCTURE & BUILDING 6.4g7 £ 48. Special Requirements Completed "`-'^�'7��• j (II 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date - - ,