HomeMy WebLinkAbout412 FORD RD - Building PermitsowtdER W. G. LONG C0.- � DATE 6-2-61
JOB ADDR.ESS 1i12-B & C rd Rd. 4� _ �» `71�>�,� 3UILDING PEAhSIT N0. 1Iy601- �
INSPECTIONS LLf/ I DATE
SUBCONTRACTOR I PERMITSISSUED
OCCUPANCY
Form Yl o--SM-11 �59 5-B P UNITS� a� �. �
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4�
OWNER W. G. LONG CO.�
;roB ADDRESS L12-A Ford
INSPECTIONS
DATE
SUBCONTRACTOR
DATE 6_p_(��
3UILDING PERMIT N0. - � (�(�nn
VALUE S ln.Fi7C�_(1n
PERMITS ISSUED
OCCUPANCY I I ��d� I I
Form 210—SM-11-59 5-8 PUNIT A�µ.�Z� NOLD FOR SPECIAL REQUII2EMENTS 1Lt600 �-
. i g����
Cb57A MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX D17 C08TA MEBA. GLIPORNIA
For Applicanf fo Fill In Compleiely
TYPE R PRINT
ADD E'SS �� ✓ � �. �"O �.0 �dl
COSTA MESA. GALIFORNIA
OWNER /Y • `�-' L O�G C O
MAIL �jOO �� C.Oii�T �GI��
ADDRESS/ /
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BHTBACK LIN6 PROM /O � B��T /� �
CeNTeR oP ernear REAR YAR/ON.-E
SIDE YARD LEFf �/'✓ ' IRIGHT `� �� '
DESCRIPTION OF WORK
BUILDING//Y � •✓ROOMS � STOF
aize T' (J
EXTCRIOR W/�,L ROOF
COVHRING 7TL�C Cp COVHRING �O C/
USE OP'BUILDING AND WORK TO BE PERFORMED
FEE RECEIV�D`;�
�p ,dAY 26�9 � .
INANCE DEPT.
CITY OF COSTA MESA �
APPLICATION FOR PERMIT �
BUILDING
For Offiee Use Only �
R6C81PT NO. J_��MIT 10. \
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RECBI GY I OA�P'^�'/� y1� �86U6p/ ,�
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BUILDING ///y �� /'� J'��n /7 �
ADDRESS '`')`' L ( /`%J T
FIRE
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LHOAL
COSTA MESA.
�� TYPE � GROUP� e� �
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NO. OP ^ / 1188 OP N¢W �
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APPROVED ALLOWED a
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1 NePBBV �CKNOWLHO6H THAT 1 HAVE PGO THIB AIVLI�,ATIpN ¢ AMOUM
AND 9T�TE TN�T TH8 ABOV6 18 GOftRHGi AND �6qH8 TO CON- pU
PLY WITH ALL CITY ONCIN/�}�CH9 AND BTATE LAWB R80UI.ATINO
auILolNa CONeTnucpop. / /f � %� VALUATION
s c�/ 773,
IZHD AGENT
ALUATI i� � R TN�
A P6HMIT FFE ONLY.
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C65TA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 9f7 COBTA MEBA. CALIFORNIA
Fo� Appl7canf fo Fill In Complefely
TYPE OR PRINT
COSTA MESA CALIFORNIA
� MAIL
� 6TATE
use or
IXIbTING BLDG.
sere�u uxe mor
� BUILDING
FEE RE('�IVED
�� ��;At' 2 � ��3b
FINANCE DEPT.
C�ITY OF COSTA MESA
PPLICATION FOR PERMIT
BUILDING
For Offiee Use Only
pHC81PT NO. _ PEF
BY
ADDRESS �/z - A �o ev ,
COSTA MESA. CALIFORNIA
TEL. LeoAL
No. � oeacxi
INO. OR BIDGe. O
NOW ON LOT p, p. �
VMD:
APPR<
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� REAR YARD -l� FROM
t I �._.._ K.�.�
DESCRIPTION OF WORK
BUILDING
OF �
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1 NfiREGY ACKNOWLCp08 THAT 1 HAVE READ TH18 APPLIGTION
ANO BTATt THAT TH8 ASOVB I6 CORRECT AND AGREE TO CON-
PLV WITM ALL CIiY Of1Dww ANCEB ANU 8T/���TTT�66''```LAWB PEOULATNO
Bl11LDING CONBTRyyTiOt�'. � , / J
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SIGNATURB OF I �.
�AUTHORIZED AGENT
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ZONING
NO. OP U8E OP NHW
PLANB BIIILDINp
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THE AMOUNT 6HOWN UNDER VALUAT�ON IB POP TH8
PUPP09i OP lBTABLI8HIN6 A PERMIT FEE ONLY.
$�
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CITY OF COSTA MESA •
a� pMFsq BIIILD/NG DIVISION
F�� 77 FAIR DRIVE, COSTA MESA, CA 92626 • i714) 754-5273 • Fax (714) 754-0856 • www.costamesaca.aov
°4�^'��o�� FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: BX11-00112
PERMIT TYPE B_MISC STATUS: ISSUED
APN: 41920103 DATE ISSUED: 10/19/2011
Zoning: , ISSUED BY: RMD _
JOB ADDRESS: 412 FORD RD CM � Suite/Unit
Vicinity: � Primary Occ: 32 - Const Type :??
SQ. FT: 400 � � Valuation: � E6,448.00
SCOPE OF WORK: "
LEGALIZE DEMOLISHED AND RECONTRUCTED 20' X30' CARPORT. REF# C11-0618 �
OWNER: ADAMS, WILLIAM DARRELL TR AND ADAMS, DOROTHYAddress:: 2535 COUNTRY CLUB DR Unit
City/State: BULLHEAD, AZ _ Zip Code: 86430
Phone: 928-704-0406 � �
APPLICANT: ANDERSON, DEBRA . A dress: Unit:
City/State: Zip Code:
Phone: 714-514-9713 � - � " ' �
CONTRAC70R: OWNER-BUILDER License No. � 000000
Address: � Unit:
City/State:
Zip Code: - Phone Cell:
ARCHITECT: . License No. - �
Phone . ' - � ' � '� .` ' ' .
ENGINEER: � . � � License No. . '
Phone .- �
FEE SUMMARY •
Building Plan Check:' ' � - . . $90.51 , . � , ., �
Building Permit: � ' 5139.25
Electrical Permit: $0.00 .
SMIP Residential . ' . . $0.64 . :
SMIP Commercial $0.00
Bldg Std Admin Fund $1:00
TOTAL FE�S $231.40
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/1812010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibiled all hours - Sundays and the following Federal Holidays:
New YearS Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivina Dav and Christmas Dav
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, § 7. 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the work authorized under this permit to be wnsidered legal, such work must comply wiih all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will resutt in the expiration of this permit.
LODEp, INSPELTIONTYPE �A[F, �RVS S.QPF.A INSPECIIONTYPE QI]F IN7171AL5
1616 Fixed System Final Fire Preven({on . 206 Final Mechanical
1268 Pool SDa Final 208 Final Plumbing
200 Final Re-Roof 210 Final EleGlrical '
201 Final BIocWRetaining Wall 212 Final Fire Prevenlion
202 Final Factory Fire Place 220 Final Planning Approval
203 Fina15ign 222 FinalSite �
204 Final Demolition 250 Final Building/Occupancy '� �^ ����
WORKERS' COMPENSA710N DECLARATION:
I hereby aKrm under penalty ot perjury one of ihe following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compensation, as provided for by section 3100 of the Labor Code, for the
peRormance of the work for which this permit is issuetl.
❑ I have antl vrill maintain workers' compensation insu2nce, as required by
section 3700 of the Labor Code, for the performance of the work for which t�is
permit is issued. My workers' wmpensation Insurance carrier and policy
number are:
Canier.
(TNs seccon neatl nor ee cwnpetea e ma pertN ia veluea et aH nuipratl tlorten (f t00) wbsnl
POlity NumEer:
Y�d'( I certify that in the pedormance of ihe work for which this permit is
i55ued, I shall not employ any person in any manner so as to become subject
1n the workers' compensation laws of Califomia, and agree that if I s�ould �
become subject to the vrorkers' compensation provisions of Section 3700 ot
the La� r CIode, I shal%l �rihwith wmp vrith these provisions.
J 9C�A.<j.l��1��11c-(�nrce �i,.-� /� 9I,-, /c� - l9 - ll
AppGrant's SignaWre Dale
'NARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE L480R CODE, INTERES7, AND
P.�ITORNEY'S FEES.
LICENSED CON7RACTORS DECLARATION:
I hereby aKrtn that I am licensetl under pmvisions of Chapter 9(commenpng
witn Section 7000) of Division 3 of the Business antl Prolessions CoCe, and
my license is in full force and eNect.
Lic. # Class #
Gontmciofa $igwWra Dalo
CONSTRUCTION LENDING AGENCY:
❑ I hereby affrm that there is a construction lending agency for the
pedormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code).
�entlers Name:
�ender's Atltlress:
onw
QWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalry of perjury that I am E%EMPT FROM THE
CONTRACTORS LICENSE LAW for the (ollovring reason (Sec. 7031,5,
6usiness and Professions Code: Any city or counry which requires a permit to
conslmct, alter, imD�ove, demolish, or repair any stmcWre, prior to ils
�Ssuance, also require5 the applicant for such permit to fle a signed statement
�hat he or she fs licensed pursuanl to the provis(ons o! ihe Contractors
license Law (Chapter 9(wmmencing with Section 7000) of Division 3 0l the
9usiness and Professions Code) or that he or she is exempt there(rom and
�he 6asis (or the alleged exempGan. Any violation of Section 7031.5 Dy any
applicant tor a permit subjects the applicant ro a civil penalry o( not more than
fl�ve �hundred dollars (8500).):
t,i' I, as owner of the propeM. o� my employees with wages as iheir sole
compensation, WILL DO THE WORK, and ihe siructure is nol intended or
oHered for sale (Sea 7044, Business and Professions Code: The Contractors
license Law does not apply to an owner of property who builds or improves
lhereon, antl who does such work himself or herself or through his oi her own
Bmployees, provitled that such improvemenis are not intentled or offeretl for
sale. If, however, ihe building or improvement is solG within one year of
Completion, the owner-builder will have the burden o( proving ihal he or she
qitl not build or improve for purpose of sale.).
d I, as owner of the property. am EJ(CLUSIVELY CONTRACTING WITH
IICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: T�e contractors License Law tices not appy to an owner of
property who builds or improves Nereon, and who wniraCts for such prol��'M�h
a wntractor(s) license pursuant lo t�e Contractors License Lavrs.).
I] I am exempt under sec.
Husiness and Professions CoAe for this reason:
�lJ'"/`f—�I
SiB�emre Da�a
305]<6 �3/07)
Ovmer ID venfed 6y driver s license. ❑ Yes ❑ No `
Driver'sLicenseNo. Expires: '1 �`l-IJ
Venfication of Ownership by (lype of document, i.e. - pmperty tax bill or tleetl):
DIVISION OF INDUSTRIAlSAFETY PERMIT CERTIFICATION:
❑ I he2by certify that no excavation five (5) or more feet in depth into which a
pef5on is r2quireA to descend, will be matle in Connection with wprk authorized
by this permit, and Nat no builtling structure, scaflol0ing, talsework, or demolition
or dismantling thereof, will be more than thirty-six (38) feet high. (Chap. 3.2, Grp
2, M 2, Sec. 341, TNe 8, Califomia Atlminist2tive Code).
❑ As owner-builder, I will not employ anyane to tlo work which woultl
require a permit from the Division of Industnal Satery, as notetl above, unless
such person has a permit to do such work from the division.
App�iwnCs SiB�eWro Oete
Division of Industrial Safety Permit Number:
HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or presenl or future building occupant need to file and
certiry a Business Plan (or emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Calilomia Healih antl Safety Cotle requires, with some
excepiions, that a Business Plan he filed wit� the Costa Meu Fire
Department by every business which has at any one lime during a reported
�qear. a quantiry of hazardous matenals equal lo or greater than a weight of
500 pounds _or a vQlume of 55 gallons, or 200 cubic (eet o( compressetl gas
at stantlara tempe7lwre antl pressure).
2. Does or will the applicant or present or tuture building occupant neea to file
a re8�stration form for awtety hazardous materials? ❑ Yes � No
(Section 25533 of the Calilornia Health antl Safety Cotle, with some
ezceptions, rep�res regist2tion wilh the Cosla 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 vreight of 500 pounds, or a
volume ot 55 gallons, or 200 cubic feet ot compressed gas at standard
temperature znd pressure).
3. Does or will the applican� or present or future building occupant need to
prepare aJ RMPP (Risk Management and Prevention Pmgram for acutety
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Healih and Safery Code provides lhat the
Costa Mesa Fire Department may require lhe preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register awtely hazartlous materials with the Fire DepartmeN.
4. If an RMPP is presently required, has Section 25534 of lhe California
Health antl Safety Code been tully complied wilh? ❑ Yes ❑ No
5. Does or will the applicani or presenl or fuWre building occUpant require for
the work which is the subject of lhis applicalion a permit tor such construction
or motlification (rom the South Coasl Air �ualiry Managemen� Districl or fmm
any other air pollution control district or agency? ❑ Ves ❑ No
(Section 65850.2 0! the Califomia Govemment Cude requires that Ihe requesled
infortnation be lumished on applications tor non-residential huilding permils).
6. Will any part of lhe (aciliry to be constructetl under this permit be vrithin
7000 feet from the outer boundanes of a school? ❑ Yes ❑ No
pf'yes", the faciliry musf ineet Ihe requirement of Sections 25534 and 42303
o( the Calitomia Health and Safery Cotle).
7. If a permit from the South Coast Air Quality Management Distric[ or other
air polWtion wntrol district or agency is requiretl for ihe work which is lhe
subject of ihis appliwtion, have all of the tlisclosures prescribed by Califomia
Health and Safery Code Seciion 42303 been made? ❑ Yes ❑ No
8. Qf'yes', attach certifcate of compliance from the appmpriate air pollution
wntml officeq.
CER7IFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is correct. I agree lo compty with all state laws and
ciry ordinances regarding Hazardous Materials antl Emissions.
Sigruwre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
ceniy under penalry of perjury that I �ave reatl this aDPlication and state that
lhe information given is correcl. I agree to compry with all state laws anA ciry
ordinances relaling to building conslruction, and authorize representatives of
the Ciry ot Costa Mesa to enter upon the a6ove-0escribetl properry for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
au npZed by th" p�e�/n i� until fi al insnpection. ) [y 7
/A^ L5� `' 1C�. /n'� 1—/%
SgnaWre of Legal Ownar(s) Data
MNor Aucnorizen Aovlicant
/
y
/ I
PX0.IECT PODNESS: 4 S Z FORD RD
OWNEfl'SNAME:��S WILLIAM
aooness:412 FbRA RD 1tA
C,M „ CA 92626
AflCH/ENGINEEfl: 7 5 1 — 9 � 3 9
R�OflESS:
flFG.NO,:
uxrt: A
UNIT:
PEflMITTEE:A—AMES PLUMBING 6 HEATING (714)530-2440
aooxess:10422 TRASI( AVENUE (��
LICENSFO CONTPACTOP DE�LpME It oN:GROVaErm inai i am iicensetl untlCAwb9 �olCfiapte� 9(commencing wii� Seclion
7000) ol Division 3 0l ��e Business and Pm�ession5 Coae. anA my license is in lull lorce ana ellect.
cirxuc.:00_� �6dq� s,nreuc.250307 ��"� `C .
Da�e: _��.i� Signamre: _
wOHNEflS' COMPENSRTION OECIAflRT10N: I Aere�y allirm tlWt I have a cenilKate of conseni to se11-insure or a cenilicate of Worker5'
Campensaiion Insurance. or a cemhetl copy t�ereol (Seclion 3800. Lah. C�.
rmicvNo.:pC941094.93 E%P.�RTE:O3�OS�9�I
' �mrner: REP UB L I C
Certifietl copy is �ere0y turnished. � CeRilietl coOY ��5 fil Q w�ilh th./e� d�y B�uiltli�np �Division.
Oaie: ��� �� Applicant: C,! `�' � —
EXEMPfION FIIOM WOXKEXS' COMPENSRTION OECIAflATION: (TI� 5¢clqn nM0 nol0e campkteE il Ihe pamA is tOr one �u�qre0 (510D) or less�.
I cetlify ihat in ihe petlormanre o� t�e work tor whi[� Iho permii is i55ueA. I shall noi employ any p¢rson in any manner w as lo �ecome
su�jec� to t�e WOrkerS' Compensa�ion Laws ol Califomia.
Oa�e: Signamre:
NOTILE: II. atter maqng t�is GecWraGon. yrou shoul0 Decome wEl�� �a the Warkers' Compe�sa6on pwNsians al I�e LaEor
CaGe. you mus� �orihwith [ompty vnl� such provtions o� Itkt permii shall Ge OeemeO revokeG.
CONSTBUCTION LENUING �GENCY: I �¢re0y affirm I�ai I�¢re i5 a ConSim[Iim I¢ndinp apency Po! IAe Detlafmante ai Ihe work fOr
which INs permitis asueE (SettiOn 3097, Civ. C�.
LENOEfl:
AOOflESS:
OwNEB 9UILOEB DECLAM7ION: I nereq' atlum ttut 1 am eKempt Irom ine fAntractof5' State L'KeRte Law tor IAe IoOowing reasOn
(S¢C�iOn 70.11.5 BuSin¢u anA Pm�essional Code: Any tily ol counly wNt� repuires a permil lo mnSlmCi. ali¢r, imprOVE, dem0liS�, Or
repair any simclure, prior lo its issuance. alw repuires t�e applipnt tor SWi perml lo lile a siA�� statement tlwt �elshe h IicenseU
pursuant m t�e provisions oi t�e Coniracmri State License Law �CtuOter 9(wmmeircinq vnth Section 7000) ol Oivivon 3 0l i�e Business
an0 Prolessions COUe) o� I�al he/s�e is e�empt I�erefrom anC I�e Dasis lor t�e allepM eremption. My violalion ol Section 7031.5 Uy
any applitant lor a petmit su0jec6 t�e applifant 10 a ciuil puulry ol irot mOre Itun INC tluMrCE Adlars (f5p1).
� I. as own¢r oi Ihe D�oOeny ar my Cmploy¢es wit� waqe5 as I�Bir SOIe cOmp¢n52tqn, wN Ga I�! work. anA IAB
j❑ simcmre is not imennea or offeretl far sale 15ec�ion )Oaa, Buvneu antl Pmfeuional CoOe: T�e Coniractors' State License �aw
' Ooes not aODN �o an owner al a D�openy wtq OuiMs w imprwes t�ereM. antl wlp OouS suN w0A �imscll/�erull or I�roup�
�is or her own employees. proviEea tlui suc� imOrwemems are nol inlen0e0 ar allere0 lar ute. II, howeve� t�e buil0inq oi
im0«'emem a sola vnihin we year ot completion. ine anner wi0 luve ttce Euraen ot Drwinp �rJs�e Uitl not EuilU or imprwe
lor Ine ourv�se of Sale�.
I, as owner ol Ihe D�openy. am e�CluSively caniracunp wi�n IicenseA mntractors to wnsirup i�e pwjeci (Section 70a4, Business
❑ anG Prolessions Wpe: The CanUactws' SWte Lkense Law ao¢s �rot aOdY la an mmer ol Drocerty ���ds or improves tAerean
anE w�o Conira[�5 lor such O�Mec6 wilh a conVacl0r�5) litense pwsuant Io Ihe CoNrac�ars' $lale License Law�. I am aware
t�al pro01 0l I�eir Wotket's CAmpenSation insuranCe 5twu10 Oe prOvi4e0 lo me.
� I am eaempl un0e� $enian: B. 8 P. C.
lor Ihis �eason:
Daie: O.mer.
I aa ner¢ey cenify thal I am aware al anU un0erstana Ine repuiremen6 0l Ghlamia HCaltn anE S3feiy CoOe $Ettions 25505, 25533. an0
255�A and Ihat loranyluture Uuiltling occupanlwilVwillnol (circle one� nee0lo comply wil� 5di0 Slal¢ Coaes antl Ihe�epuirementslora
pe�mii lor consimtlion or mo0ilaaiion imm I�e Nr OuaOty Managemen� USlnci. fkSiEenlial cOnslruciian apDliwtians a�e eKemp� imm
�he5e provi5ion5.
Daie: AppGcant:
I �ere�y tetlily I�ai I fwve rea01N5 application and Siate Itwl Ihe aDove inbrmaiion i5 corrEtt. I agree �o wmply wii� all [iiy an0 COUniy
ordmances an� stalelawsrelatingto �uil0inp consimclion antl hereEyauihoraereprBsenta�ives oilhis ciiylo enleruDonihe a�ove�menlione0
pm0etly br in50ec�ion DurDases. • ��
� n � �,
Oa�e. � ��� Signaiure•
�river'S License or Soclal $ecurity
� 16d�-66 Wlme—Builtlmg: Green—Co�e En�orcement: Canary—AOPlicanL Pmk—Rnvenue; Goltlonrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 062695
PERMIT NO; M 062695 PLAN CHECK NO; N GOVT; N SUPP; N �`
CONSTRUCTION TYP —N � PE ZT TYPE; MEC PURPOSE: OTH
JOB DESCRIPTION ; REPLACE FAU Q FT:
CLAIM VALUE; CALC— UE; OUP OCC: R-3 /
COMMENTS; NO OTHER ZED HY THIS PERMIT
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Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL: 91920103 ZNE; REF NO;
PLANNING NUTES>
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D E V E L O P M E N T S E R:V I C E S R E Q U I R E M E N T S
20NING APPROVED BY �, DATE;
BUILDING APPROVED BY ; ___ DATE: .
APPLICATION ZSSUED BY: ' �% �� DATE;� ��
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LEGALIZATION;N F E E .S Q M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 9,00
25Y SMIP/NON—RES
ISSUE FEE �i% 15.00
BUILDING—DIV—> PERMIT ZSSUE PL�AN—CHECK TOTAL PAID DUE
TOTALS----> 9.00 15,00 �. � 0.00 24,00 24,00 ,00
�
REVENUE DIVISION TOTALS--> COLZECTED• 24,00 OVER/SHORT; 00
HLDG PMT PLUMBING ELECTRIC MECHANI� FIRE SMIP/TOT GRADING PLAN—CHECFt
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', I N D I V I D U A L'� F E E B R E A K D O W N
ITYPE QTY D E S C R I P T I O�N' UNIT COST TOTAL COST
4.'
MEC 1 INST FORC—AIR/GRAV'FURN <= 100 K BTU 9,00 9,00
END OF FEES
�1 0�14142Q—QD1�1<28 T i�T 24.�J0
DATE: 06/22/9'a TIfiE: 12:25
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, - -
CONSTRUCTION ANDPLANNING
APPROVALS Permit#
1. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd. �-� -
3. Electrical Conduit Utility-Undrg�nd.
4. Electrical Conduit�Undrgrnd. �
5. Steei Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Foundation a t
, F
9. Water Pipe•Undrgrnd. � %�
a_
10. Structural Floor Svstem ;_7"
17. Property Sewer Line & Hous�,Connection
� 12. Sewer Cap "'
13. Roof Drains
" ( 14. Aough Plumbing
- 15. Rough Eleccrical•Condua
16. Rough Electric4Viring
77. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19, Rough Heating & Air Conditloning _
20. Rough Factory Fireplace ' '„
21, Ducts,in Structure
22. Ducts, VRntilatin9 � �
23. GasPipe-Rough & Test � ���
24. Roof Framing � �
25. Roof Sheathing
26. T-Bar Ceiling (Stractural) & Monocoat
27. Frame and Flashing - �
28. Lathing $i Siding '
29. Insulation � '
30. Drywall Nailing
31. Plaster Brown Coat � .
32. Electrical Power MeterFinal ,
�a.�Final Electnc �
34. Final Heacing & Air Conditioning
36. Hood or Canopy -
37. Final Factory Fireplace . .
38. Final Plumbing ' �
39. �Vater Service�Final
40. Gas ' vice-Final .� . �
41. Sol , Domesti�'�'lir ai4y,�
42. Ba flow Pr�penter
�
43.�ackflow��iigation �
44. Landsca Irriyatiori System �
45. fiound Attenuation
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING
48. fINALPLANNING -
49. Electric Release to Edison
50. Gas Release to Southern California Gas G
51. CERTIFICATE OF OCCUPANCY
No. Date
Date Inspeetor
�'
n
0
n
0
PO SPA
APPROVALS Permit # Date Inspector
52. Pool & Equipment Location
53. Steel Reinforceme�t
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
56. Electrical Conduit�Undrgr�d.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrica�-Final
66. Solar System-Final
67. Fencing & Access ApProval
68. APPROVED FOR PIASTERING
69. POOL/SPASYSTEPASFINAL
.FIREDEPT.REQUIREMENT
APPRdVALS Permit#
70. Underground Hydro .
71. Product Piping O Gas ❑ Oil
72. Underground Flush
73. Undergmd. Storage�Tank f� Gas ❑ Oil
74. Overhead Hydro
75. .Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEAITH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFiCATE ISSUED
Notes: $���-�//D _ .
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