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HomeMy WebLinkAbout236 FISCHER AVE - Building Permits •• Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. _ .• CITY,OF.COSTA MESA PERMIT NO.Q P�y-- TRACT NO. - LOT NO. BLDG.NO. - - -, CONSTRUCTION PERMIT 1. 3 / .,2a • • Project Address� 23 ��S eJe�f� ` TYPE OF CONSTRUCTION • B3O� (/ ]/82 14 .. .I . Owner' Al t-e LUE/�''^Fat 1 'phon¢ ❑'NEW ❑ ADD 0 ALTERATION �� • ' Address'2\31-t Foss{ r ❑ REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS - //�� Arch/Eng.` `• Y` License No. 0 OTHER • A P �'O Address - DESCRIPTION OF WORK • ' /// ZONE PLNG. REF.* Contractor !l/ 3' tit 7 Phone57442#275TYPE OF PERMIT - BUILDING -• Op gUL7ILLppING / SETBACK C/L ST. �ROBPEl3'rV LINE cis Address- , es6 Rn/2� � AA_ ❑.GRADING ❑ FOUNDATION 0 STRUCTURAL SILIDE YARD - - - - 1LICENSED CONTRACTOR DECLARATION ❑ TENANT ELECTRICAL OPLUMBING ❑MECHANICAL SIDE YARD - - . - ` I hereby affirm thkt I am licensed under provisions of Charter 9 (corn- RIGHT Nmencing-with section 7000) of Division 3 of the Business and 0 OTHER Professions Code, yn l license is In full force and effect. REAR YARD(TO P/L) C.�_'- PROJECT DESCRIPTION Licen��.lC-la y ense No.� PKG.SPACE REQ. • PROVIDED DateVta ? Signature �+ psy v. 'L� -C - SQ' FT' STREET WIDTH PARK FEE$ - -WORKERS'COMPENSATION D:' ' V' ON -- OCCUPANCY-CONSTRUCTION TYPE I hereby affirm that I have a certi .te of consent to self-Insure or,a VALUATION _ ZONE ZONING APPROVED BY • I DATE certificate of Workers' Compensation Insurance. or a certified copy - preof Sect 3800 Lab. SPECIAL CONDITIONS: -0. ( {�r1T/ GRADING CU.YDS. ACRES ,s�"•icy No. n.•:�/� ,lrtfpany StFI'T6 rA2M ' ^'...Jt.9.Certified copy Is hereby furnished. . - ., .REMARKS: ' erdfied copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - • • (This section need not be completed If the permit is for_one hundred - - ($ 100) or less). -• •- - '- 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. .DWELLING GARAGE Date Signature BATHTUBS SHOWERS - - SD.FT. SO FT NOTICE: if after'making this declaration, you should become subject TOILETS URINALS - GENERATOR '0-1 KW.=1-10 KW . to the Workers' Compensation provisions of the Labor Code,you mustTRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS . - -APPLIANCE 10-50 KW 50+ KW revoked. CONSTRUCTION LENDING AGENCY KIT:SINKS - DISHWASHERS MOTORS 0-1 HP 1-10 HP - ' - - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS • - - (INC.SOLAR) 10-50 HP 50 +HP formance of the work for which this permit Is issued (Section 3097 - Clv. C.). - - - FLOOR SINKS FLOOR DRAINS • - - - FIXTURES OUTLETS SWITCHES - Lender's Name - - Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS - OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS - ' POLE LIGHTS - - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - . LUNS I KUL I IDN • Any city or county which requires a permit to construct, alter, POLES METERED SUB ' improve, demolish or repair any structure, prior to itrissuance,also re- WATER SERVICE - ALTERATION. -' " • PANELS I ' MAIN , SUB D /0 00quires the ap.licant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law- GAS SERVICE OUTLETS [ s.� •j ' SERVICE 1 - AM PI Oe) , S" 00 (Chapter 9 (commencing with Section 7000) of Division 3 of the 'ness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT , - for the alleged exemption. Any violation of Section 7031.5 by -- applicant-for a-permit subjects the applicant to a Civil penalty ' SEWER CONNECTIONS . - . " - • or not more than five hundred dollars ($500). ❑ I, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - T - .sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE - 3 oO Contractor's License Law does not apply to an owner of a property _ _ _ , who builds or improves thereon, and who does such work himself or ISSUE FEEAPPLICATION APPROVED BY DATE - through his own employees, provided that such Improvements are not . - intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK --SUMMARY OF FEES is sold within one year of completlon,,the owner will have the burden • O of proving he did not build or improve for the purpose of sale).' BUILDING - .. I, as owner'of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ AND DUCTING PLAN CHECK $ PERMIT licensed I, cownart o rf totconstruct the project (Sectiony7044, Businesswith 100,000 +BTU and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ IR an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100.000 BTU PLUMBING $ SI tracts from such projects with a contractor(s) licesned pursuant to• SYSTEM GRADING. S the Contractor's License Law). 100,000+BTU_ PLAN CHECK $ p - 0 I am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $ I fh ' • tr� $ '! reason -- - • - - - MICROFILM E SYSTEM REPAIR.ALTERATION PLAN CHECK $ - • Date Owner •TOTAL FEE$ MECHANICAL E I hereby certify that I have read this application nd state that the above EXHAUST SYSTEM MULTIPLE - information i correct. I gree to comply w h all city and county- -PLAN CHECK $ -- LESSP VANCE NCE PC $_ Q representati i .• tate laws r ytl t9 to constr ucti ,and hereby authorize representati of t c y to errrssdtter e above mentioned typo[ �� l. property fa spect n rp s. %'� FINAL FEE ELIv Signature � "' • sate C ft/rivers'tic e or S . - ISSUE FEE - - . CMF 0865-46 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 43. Pool & Equipment Location. - - -- ' . I 2. . Soil Pipe-Undrgrn _ - 44. Steel Reinforcement • / ' 3. Electrical Conduit Utility-Undrgrn . . . 45. Forms _ ...- 4. Electrical Conduit-Undrgrn - _ • 46. Electrical Bonding, - •• - - - _ 5. _Steel Reinforce 47. Rough Plumbing&Pressure Test - . - - .V`, - 6. Electrical UFER_Grn _ 48. APPROVAL TO COVER-GUNITE . ; .r- . - . _7. Footings49. Electrical Conduit-Undrqrn B- Foundation -_ 50. Gas Pipe,- ❑Undrgrn,Test . • - - ._9. Water Pipe•Undrgrn - . .. . - 51. Backwash Lines,P-Trap, ❑ Undrqrn • - • - 10. Structural Floor System - - 52. APPROVAL TO DECK - : 1.1. Property Sewer Line & House Cohnection - _ .- 53.. Backwash & Receptor-Final, • - 12. Street Sewer Connection . . - - 54. Heater& Vent-Final - •- 13. Rough Plumbing __ , _ - 55. Plumbing System - Final - - 14. Rough Electric-Conduit - . - -- - -56. Electrical-Final •- 15. Rough Electric-Wiring - - 57. Solar System-Final - ' ' 16. Rough Heating &Air Conditioning • 5B- Fencing&Access Approval 17. Ducts,in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating . - 19. Gas Pipe-Rough &Test - • - 60. POOL/SPA SYSTEMS FINAL ' 20. Roof Framing - - . - - • - • 21. 'Roof Sheathing - - - - • . -• - - 22. Frame and Flashing - NOTES: - 23. Insulation - . - ._ • 24. Lathing & Siding - - -- - - - 25. Drywall Nailing - • . . - - - . ' . -' 26. Plaster Brown Coat �Z - - • 27. •Electrical'Power.Meter-Final - YK 0 ead - - • 28. Final Electric - ).-7.47. 4'11' -- - 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 System - 36. Sound Attenuation - - 37. Handicap Regulations - - • 38. FI NAL 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 - - • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. •- • �_ City OF COSTA MESA PERMIT NO. ' i TRACT NO. LOT NO. BLDG.NO. s • CONSTRUCTION PERMIT -a—Jr-7i -� / 9092 6/22/82 20.00 TL, Project Address 6 F� .hcbte R TYPE OF CONSTRUCTION _ • Owner -plotc-'t tLL_.45 - Phone 0 NEW 0 ADD 0 ALTERATION ejn,s tz? Address 1.3r;gk&R - ❑ REPAIR ❑CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER ZONING REGULATIONS '� - _ _ - DESCRIPTION OF WORK ' A.P. U ' Address - ZONE ?LNG.REF.# '.‘ ,Contractor p, G F6"� T Phone 'TYPE OF PERMIT BUILDING TTp g�1I --PING - - . 1 v u�S SETBACK C/L ST. 7 ROPERT a LINE Address ,�h/ ��n p�, ❑ GRADIN FOUNDATION ❑'STRUCTURAL LSIDE YARD _ - LICENSED CONTRACTOR DECLARAT - EFT 0TENANT ELECTRICAL ❑PLUMBING ['MECHANICAL D herebyYARD - - Iaffirm that I am licensed under provisions of Charter9 (Com• RIGHT GH mendng with section 7000)- of Division 3.of the Business and 0 OTHER Professions Code and my license Is In full force and elf-at. ' REAR YARD(TO P/L) _ D PROJECT DESCRIPTION _ __ • _ _ __ License Class Liu ns No.e- ' PKG.SPACE REO .. PROVIDED" . ' Date - - -S Signature �) . .— SO.FT. - ` __ -_ - . - ,WORKERS'COMPENSATION DEC,V• •fDO v - -- •' OCCUPANCY_CONSTRUCTION TYPE _ 'STREET WIDTH - • PARK�FEE$ I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED.BY DATE certificate of Workers' Compensation Insurance, or a certified copy • -• - _ _ eof(Section 3800,Lab.C.). GRADING CU.,V OS. SPECIAL CONDITIONS: ACRES - - -Y No. Company __ - -. _ - • - _ . . _ _ _ Li Certified copy is-hereby-furnished. - - _ ..REMARKS:'-• _ _ .__ . __. . . _ _. _ __ _- • ❑ Certified copy Is filed with the city Building Division. , EXEMPTION FROM WORKERS' COMPENSATION'DECLARATION . - -'"" - - - - - ' -- (This section need not be completed if the permit is for one hundred, . - ($100) or less). - . _ _ - _ - _ - .__- - . . __--_ '- _ . - - _ _ _ I certify that in theperformance 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._- BATHTUBS l- SHOWERS DWELLING.- GARACaE - - Date - Signature ' - 50 FT NOTICE: If after making this declaration, you should become subject TOILETS ,URINALS _-"• - GENERATOR -0-1'KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER - -r forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - - APPLIANCE 10-50•KW=50+-KW- -- "--,. CONSTRUCTION LENDING AGENCY KIT.SINKS" - - DISHWASHERS _ -•- MOTORS - - '0'1 HP_1,10 HP •' --/ - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS ' SUMPS + 'UNC..SOLAR) 10-50-HP 50+-HP- (j Q,- - H - . formance of the work for which this permit is issued (Section 3097 L ""` Civ: C:). - _ - _ ' - . . -- FLOOR SINKS - FLOOR DRAINS - _- -FIXTURES -v OUTLETS'C,SWITCHES Cl i.7 e Lender's Name _ _ __ Lender's Address DRINKING FOUNTAINS , - • 'GAS TUBE SIGNS - - - - -• , OWNER BUILDER DECLARATION- - INTERCEPTORS CLARIFIERS -- - '•POLE LIGHTS- ' - - - - — '- I hereby affirm that I am exempt from the Contractor's License Law for , - the-following reason (Section 7031.5-Business and Professions Code: SWIMMING POOL' - P TRAP LUNO i RUL I IDN_. - - Any city or county which requires a permit to construct, alter, _ - ,POLES METERED -SUB improve,demolish or repair any structure, prior to Its Issuance,also re- WATER SERVICE- - ALTERATION - . PANELS MAIN SUB - - — ) quires the apkiicant for such permit to file a signed statement that he - -- - is ❑tensed pursuant to the provisions of the Contractor's'License Law GAS SERV ICE OUTLETS - SERVICE- AMP- (C4g)?ter 9 (commencing with Section 7000) of Division 3 of the • f»f;rss5 and Professions Code) or that ne'Is-exempt'thorefrom and the WATER HEATERS - BTU OUTPUT- - - - - -' - -• -- --- - - - v i -zgor the alleged exemption. Any violation of Section 7031.5 by - - - • ` a°`'MM'appilcant for a permit subjects the applicant to a civil penalty ' SEWER CONNECTIONS — '- -- - -- of not more than five hundred dollars ($500). I' - - ' ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK" COLLECTORS- • - --- -- - - - sole.compensalion, wlll.do the work,and the structure Is not Intended _ _ _ - "' '• - ;wT or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS- - , - ISSUE FEE ' .' VCJ Contractor's License Law does not apply,to an ownerofa property _ , who builds or improves thereon, and who does such work himself or ISSUE FEE , - - APPLICATIONAPPROVED BY • - - through.his own employees, provided that such improvements aro not - —- - Intended or offered for sale. If, however, the building or Improvement MECHANICAL - CHECK J SUMMARY OF,FEES - ,� issoldwithin one year of.completion,the owner will have the burden - ' , f' of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING-- - - - - - . - - property,- Y' 9 AND DUCTING - I. -• __ IPERMIT _-_.- - - •_ _ _ - _- • 0-1, as owner of theam exclusive) contracting with _f _$ - SMIF,-• . • $- licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHECK $ ,PERMIT. • and•Professions Coder The Contractor's License Law does not apply to - ISSUANCE $ ' ft, an owner of property who builds or improves.thereon,and who con- REFRIGERATION 0-100,000 BTU ,PLUMBING - _ `.1 tracts-from such projects-with a contractor(s) licesned pursuant to SYSTEM $ .. - GRADING $ ) the Contractor's License Law). 100,000+BTU PLAN CHECK S- ❑ I am exempt under Section -- B.8 P.C.for this BOILERS BTUa`� $ - ' 'ELECTRICAL $ d reason -' - - - - - PLAN CHECK ' $ -- - MICROFILM $ ' r• • - SYSTEM REPAIR,ALTERATION ) Date- Owner - ' TOTAL FEE$ - * • MECHANICAL E • I hereby certify that I have read is application an• .tate that the above EXHAUST SYSTEM MULTIPLE • • 'LESS AO- Q information is erred. I ag to comply wit II city and county PLAN CHECK E - VANCE PC $_ ordinances and s •te laws rel. t ,_ucti0 nd hereby authorize s , representatives/.f this cit to enter e above mentioned nn property-for speedo ,` poses, FINAL FEE $ CX 9 '©n Signature •, • `��—a. A Date fie.— - - - - Drivers'Lit�. ISSUE FEE- . - - - --- - - -- — - -_ ' CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor • ' CONSTRUCTION'AND PLANNING , POOL&SPA < APPROVALS Permit# Date Inspector APPROVALSPermit# Date _ - Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location • - • - - • - 2. "Soil Pipe-Undrgrn "- 44. Steel Reinforcement - ' 3. Electrical Conduit Utility-Undrgrn - 45. Forms - " • - • 4. .Electrical.Conduit-Undrgrn _ - 46. Electrical Bonding 5.. Steel Reinforce - J 47. Rough Plumbing & Pressure Test - - - e 6. Electrical UFERGrn _ _ 48. APPROVAL TO COVER•GUNITE•. - . . - - 7. Footings . . - - - 49. Electrical Conduit-Undrgrn• 8. Foundation . • . _ - _ • __ 50. Gas Pipe, ❑Undrgrn,Test - • • I _ 9. Water pipe-Undrgrn _ __. ': . 51. Backwash Lines,P-Trap. 0 Undrgrn' - - 10. Structural Floor System - 52. APPROVAL TO DECK • 11. Property Sewer Line & House Connection _ 53. Backwash & Receptor-Final • 12. Street Sewer Connection. .. ' - . 54. Heater & Vent-Final • 13. Rough Plumbing _ - 55 Plumbina•Svatem: Final - - 14. Rough Electric-Conduit : • -- . - :56. • Electrical-Final - , • 15. Rough Electric-Wiring - - 57. Solar System-Final - 16. Rough Heating&Air Conditioning - . - 58. Fencing&Access Approval , - 17. -Ducts,in Structure - -. . . _ .59. APPROVED FOR PLASTERING ' 18.- Ducts, Ventilating - _. . . " _ 19. Gas Pipe-Rough &Test ,-• - 60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing _ -• - _ _•i • ' 21. Roof Sheathing .. - - . . 22.. Frame and Flashing - . NOTES: _ • 23. Insulation - . , - - - . - - _ _ 24. Lathing & Siding -. • •-" - ' • 25. " Drywall Nailing . . - 26. Plaster Brown Coat - - - . - - ' 27. Electrical Power Meter-Final _ - - . - - _ . " 28. Final Electric- --- - - . "7-TC7-�i j9`�- , 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 System ' ' 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 _ , - .•", ;- i PFVECT ADDRESS: 236 FISCHER AV UNIT: _ CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05640: OWNER'S FME: FRED E-LL I5^ - '. ADDRESS: 1857 IRVINE PERMIT NO; E 056402 PLAN CHECK NO: N GOVT: N SUPP: N NEWPORT BEACH CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : SERVICE METER SQFT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC ; B-2 / ADDRESS: LARRY JONES ( 714 ) 650-3170 CM , 2026 POMONA CA 92627 COMMENTS ; NO T. I . LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R EQUIR EMENTS 7000)of Division 3 of the Business and Professions Code,and my license—�is in full force and effect. SETBACKS CITY LIG.: ?3 5 5"7 STATE LIC.:401687 g � d C T\3 -- 1-3'97 signature !/ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECIMATION: I hereby affirm that have ace dicate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800. Lab.C). LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN 1 POLICY NO.: EXP.DATE: COMPANY: PARKING RE(O' PROV: PARCEL: 00000000 ZNE: REF NO: 3 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> Date: - . Applicant: *************************3f*****lX ****************3Fia*)EiF****ie1F********?E***N-******IF EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need nal be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ a arson In ny manner so as to become subject to In workers'Compensation Laws of California. ZONING APPROVED BY [..- DATE:Signature. NOTICE:II,alter making this declaration,you should be me subject the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : f DATE• Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. F CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• •r �� DATE• 3— �-- "4 7� which this permit is issued(Section 3097,Civ.C). ****3f-****.*******************************. ***********************-*****3+******** LENDER: ******* ***************************************3c?F********3f•****36**************** ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of 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 PERMIT 18 , 50 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 O t SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15 ,00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 18 . 50 15 , 00 0. 00 33 , 50 33 , 50 . 00 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 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 REVENUE DIVISION TOTALS--> COLLECTED; 33. 50 OVER/SHORT: ,00 for the purpose of sale). BLDG PMT PLUaMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 33 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such protects with acontractor(s)license pursuant to the Contractors'State License Law).I am aware **'*********Y..*.*.3fX.*.*.***..*.*..X.:1.**..*..**.*.*.**.***.***.*.*.if.%.*.***3(.**.*.*.*if,Y.*****..*.ii**.**iE*********** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN El I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and 25534 and that I or any future building occupant witlwit not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for' pection purp es. ri' - rr _ _ _ 'Eli�' Z ,I/(���/�/ D. Tu : nt.. ,� :• Beer i Signature: X — '� 7 Driver's License or Social Security a: l/ , 1641.46 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor - POs ,� SPA •� CONSTRUCTION AND PLANNING J) APPROVALS Permit# - Date f 'Inspector APPROVALS Permit # Date Inspector ' ): Temporary Electrical Service'or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. ^ 53. Steel Reinforcement 1 3. Electrical Conduit Utility-Uhdrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 51 Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation ^ ' 59. Gas Pipe, 0 Undrgrnd., Test - 7 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 I 65. Electrical-Final 15. Rough Electrical-Conduitl 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# 71. 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT I 31. Plaster Brown Coat ti 79. FINAL INSPECTION 32. Electrical Power Meter-Final 7'Z-17 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test • n 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 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 sJ 51.. CERTIFICATE OF OCCUPANCY t No. Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. I • CITY OF COSTA MESACO,flI$TRUCTION,PERMIT R � TRACT NO. LOT NO. UNIT NO. • . Project Address 2,S C eSeAec.P d� L• fi �a� �� `� S..5" i S ' Applicant's Mailing Address .2/(4- I'SCHEde 4b1 e,47 TYPE OF CONSTRUCTION O NEW L7ADD LI ALTERATION LI REPAIR 5911 12/16/PR 17: TL -Y �./ ���3 ❑ CONVERSION 0 DEMOLISH 0 OTHER . • Owq is Name FAW-.0 {!A/ FI-1/S Phon Set - -- A.P.# I Zone J `/ /� DESCRIPTION OF WORK/USE OF BLDG. Ad reS.2-'74 /OS&Veit ,4vE, l_ioStA7AICSA l-TI� S Main Building: - Accessory Building: Z • Arch/Eng. - - - _ License No. _ TYPE OF PERMIT 0 GRADING LI FOUNDATION L7 STRUCTURAL E Front 0 Address 1^ li • 0 TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear - N Contractor's Name (I 1,1, Phone ❑ OTHER .y MMUPA A I Address(mailing) ` PROJECT DESCRIPTION SQ. FT.-70(J Z- t 7�Z6CCUPAN ^• C Right N CONSTRUCTION TYPE VALUATION S Left - R City License No. ZONE GRADING CU.YDS. .ACR '""� C - '� E- LICENSED CONTRACTOR DECLARATION _ 1 ..J Ping. Ref.# Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9(commencing ,c, ,met Planning Notes: EXPIRE n M with section 7000) of Division 3 of the Business and Professions Code,and -- my license is in full torte and effect. • /44,-- . I�L�Inp/efe inspeetin T License Class License No. - '� r (.,� S _ S Date Signature -.. .Date 7/zyonc�ee1��aa' ' • WORKERS'COMPENSATION DECLARATION !ink . Showers FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate _ , 'f Workers' Compensation Insurance, or a certified copy thereof (Section 800, Lab. C.) _ _ Backflow Preventer Service Sink Automatic 4asher - Transformer 0 15-50 KW Policy Na. Company • Backflow Irrigation Sewer Cap Construction Pole Sub. 80 50+ I�W Certified copy is hereby furnished. Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection . Cooking Unit • Meter Cup to 100 antis Date - Applicant • Li EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ' Clarifiers Solar Collectors • Dishwasher Meter Dover 100 amps ' (This section need not be completed if the permit is for,one hundred ($100)or - less). Dishwasher 'Solar Piping Dryers ❑Gas DElectric • Sub Panel ' I certify that in the performance of the work for which this pe mit is iss •d, I — - shall'not employ any person in an - Drinking Fountains Solar Tank Fan Motors 00-1 HP 0)11.4-8 Worker C y ens Laws of Cay mann as to becom s bjecliforni@ec�su�^ �/y^) I ' •f— I - Date/<- ^ Signature /��1/ ) (i / i� Floor Drains Swimming Pool vv/Spa F.A.U. 'NOVICE:11,after making this declaration,y u sh uld become su8ect to the — _ Inc.Solar ❑B-1$HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures • comply with such provisions or. this permit shall be deemed revoked. - - - Microwave _ CONSTRUCTION LENDING AGENCY • Gas Service Outlets Water ClosetDevice Boxes Pole Li ht . I hereby affirrii that there is a.construction'lending agency for the performance- - ' 9 of the work for which permit is issued (Section 3097 Civ. C.) Interceptors Water Heater " _ Outlets Range Lender's Name - _ , Lender's Address _ Kitchen Sink Water Service .... . jyC) it t ' Switches' • OWNER BUILDER DECLARATION _ ' • Sign ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash C 11C.C.� Garbo ¢Disposal • following• reason (Section 7031.5 Business and Professional Code: Any city or ii _ 9 D ;Standing Sections ' countywhich requires a permit to construct,alter,improve,demolish or repair mss• , • q P P P-Trap ,Laundry Trays,,,.,, -<-" Generator ❑0-5 KW ❑5-15 KW •Trash Com actor ' tooy fileera signedgre, prior tom its shat-he/, also requires the pursuantto applicant for such provisions permit Vim•_ _ - P a sa License Law at-he/she is licensed to the of Roof Drains • the Contractor's La (Chapter 9(commencing with Section is7000) of • D Division'3 of the Business and Professions Code) or that he/she is exempt V �.l t t� '031.5• om and the basis for the alleged exemption. Any violation of Section E /� rt}Qn5 by any applicant for a permit subjects the applicant to a civil O (QSDev / zenalty of not more than five hundred dollars($500). l flet) (-I�,1'�' /]//. $ 3 ♦ as owner of the property or my employees with wages as their sole -Reinspection Fee I $15 I �ee' ♦//�'1/r • it/' Compensation, will do the work,and the structure is not intended or offered - 1111 r' 1a� - Reinspection Fee $15 Issue Fee' $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECH .CAL •y1�' FEES License Law does not apply to an owner of a property who builds or improves I - - 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 ❑ sale. If, however,the building or improvement Is sold within one year of com- - Canopy Type II 0 ' Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct Under Ground 1 Building Appioved By Date prove for the purpose of sale). . - �] Q "Kel, es owner of the property, am exclusively contracting with licensed con- Duct-Structural 1 Refrigeration System Application Issued By L rI Dat S� tP ctors.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 i . 00-100,000 BTU ❑100,000 BTU SU AR OF S �j builds or license s thereon,'tand won contracts for such w) 'I projects with et con- - _ �� $ Si.73 • tractor of license orker's to the Coon ins rra License be I aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ QQ^� proof of their Worker's Compensation insurance should be provided to me:' • 83 L_PLAN CHECK $ . (P•C� PERMIT ' 0 I am exempt under Section 8. P.C •r this reason • Firepl/Fact.Blt. ICBG 4 Fire Dampers PLUMBING, $ ISSUANCE $ 9Ducting RegistersENERGY P.C. $ Date e y certify - j`1 owner / ♦ A. � i ._.O Hearin System& PLAN CHECK 25% $ - I h eby certify that I have sea• t Is application an• sta e that the a•• e 00-100,000 BTU 0100,000BTU' ' i GRADING $ • Information is correct:) agree to-comply with all city .nd county repre- ordinances - ' - - - ELECTRICAL $ and state laws relating to building construction,and hereby authorize sPLAN CHECK 50% $ MICROFILM $ Inspection sentatives of this city.4o enter'up n the ove-r)entioned property or inspection outposts. /I / MECHANICAL $ TOTAL FEE $ Signature �� /•�.. • Reinspection Fee $15 _ Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building; Canary.-Applicant; Pink - Accounting; Goldenrod - Assessor - • ' - i • e . CONSTRUCTrION AND PLANNING • - POO. . SPA APPF.5VALS • Permit# - - Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . ' . 2. -S7I 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 y 6. Electrical UE ER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings . . I/jnit �4 j5 58. Electrical Conduif-Undrgrnd. ``Ilii ^-7!/ .. r 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 i 65. Electrical-Final - 15. Rough Electrical-Conduit 66. Solar System-Final • 16. Rough Electric Wiring . • 67. Fencing & Access Approval • 1-7. '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 I' - 20. Rough Factory Fireplace .... APPROVALS Permit# 21. Ducts, in Structure 70. Undergroun8'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.E Roof Sheathing . 74. Overhead Hydro I 26. T-Bar Ceiling (Structural) & fvI nocoat 75 Dry Chemical 27.: Frame and Flashing 76. Dry Standpipe '28.\Lathing &Siding77. 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-Final r 40. Gas Service-Final . 41. Solar Domestic-Final . . ,- . 42. Backflow Preventer 43. Backflow Irrigation . 44. Landscape Irrigation System • 45. Sound Attenuation .:j t` 46. Handicap Regulations r/ 47. FINAL STRUCTURE & BUILDINGY• - 48. Special,Requirements Completed 49. Electric Release to Edison - - - - - 50. 'Gas Release to Southern California Gas Co 51. CERTIFICATEOF OCCUPANCY ' • No. " Date U. '