HomeMy WebLinkAbout400 ANTON BLVD - Building Permits^ ICi7vo�COAS�AME�_CONSTRUCTI
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ADG���anl to fill in all spaces except lhose within heavy OorCer lines antl si9� all appropriale tleclarations.
Applicant'sMailingAddre.y55 -
Owner's Name �� � �F �. ��� '� Phone
Address
' Arch/Eng. Licenu No. '
Address
Contractor's Name«M�e�J Cc � P,hone `!7Y 9670-
A'ddress Imailingl �U� Auv /7 75�7 1'r��+< P. QA7l,j
Ciry License No. �Zz 79
LICENSED CONTRACTOR DECLAftATION
1 hereby affirm that I am Iicensetl untler Orovislons of Charter 9(commencing
wi[h section ]000) oi DiviSiOn 3 ot Ihe BuSiness antl Profe55ion5 Cotle, antl
my li<ense is in tull forcc antl eHect.
License Class '�% Li ense rvo. � fry0 8' S'
Dale �"���� Si9nature
WORKERS' COMPENSATION DECLARA ION
1 hereby afiirm that' I have a certiticate ol consent to self-insure or a certiticate
of Workers' Compensa[ion Insu�an<e, o� a cartifietl coOY thareof (SecUon
800, Lab. C.) � �
/oiicy rvoJ��'FX9Sf.5 S�L' Company /�+%�
. 8Cer[ifietl capy is h¢reby futnlsnetl. .
Cer ietl copy is (iled with the city B�ry tlin9 Divisis n, n
Date ��'�'1' qpplican[ /�vir�P U• �{1ri./-a'�e+..�
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(ThiS sectlOn neetl no[ be completetl if lhe Oe�miLiS for on¢ huntl�etl (E100) or
Iess).
I certi/y lhat in the perto�mance of the work for which this perm�t i5 issuetl, I
shalf not employ any pe�son in any manne� so as to Decome subject to the
Workers' Compensatlon Laws of Calitornia.
. Date Si9nature
'NOTICE: If, after making this tleclaration, you zhoultl become subject to the
Workers'.Compensalion O�ovi5ion5 of [he l2bor Cotle, you mus[ fo�thwlth
compry witM1 Such provi5ion5 or this pe�mit shall be tleemetl revoketl.
CONSTfiUCTION LENDING AGENCV
, I nereby aifirm Mat there is a mnsiruction lentling agency for the periormance .
,ot lh¢ work for wM1ich tM1is permit i5 issuetl (Saction 3097 Civ. C.)
LenUe�'S Name
Lentlet's Atltlress �
OWNER BUILDER �ECLARATION
I hereby �aHlrm that 1 am exempt irom the ConVactor's Licenso Law for the
. following reason (Section 7031.5 Business antl Professlonal Cotle: Any cl[y or
counry whiGh requires a permit to can5truct, alte�, ImOrove, tl¢mOlisb o� repair
any sfructure, prior to its issuance, also requires Ihe applicant lor such permit
to file a signetl Statement lhdt he/She IS IiCensetl pursuant to Me provisions of
, the ConVaCtor'S License Law (Chapter 9(mmmencin9 with Sectlon'7000) of
Division $ of the Business antl Profe55ion5 Cotle) br Ihat ha/sne.is exempl
tM1erefrom antl the basis fo� lh¢ allegetl exemptiOn. Any violatlon of Sectlon
1031.5 by any �ap0���ant fOr a permit Subjec[s the applicant -[o a tivil
ienalty of not more lhan five nuntlretl tlollars (5500). .
� I, as owne� ot lhe property or my em0loyee5 with wages as their sole
compensation, will tlo the work, antl tne slruchre is nol intentletl or offeretl
for sale (Section 7044, Business antl�Professional Cotle: Thn,Con(ractor's
License �nw does n0[ apply to an owner of a property who builtls Or improve5
thereon, antl who tloes such work himself/herself or Ihrough his or her own
i employees, provitled [hat such improvaments are nOt Intentle0 or o(feretl fo�
sale. If, nowever, the builtlin9 or improvement is soltl within one year ot com-
pletion, tlte owner will have the burtlen of proving h¢/she tlitl not builtl or Im-
p�ova tor LM1e Ourpose of sale).
❑ I az owner of [he Dioperty, am exclusivelY contraGting with Ilcensetl ron-
tractorst6 constructthe project (Section 7044, Business antl Professions Cotle:
The Contractor's License Law tloes not appry to an owner ot properly who
builds or improves thereon, antl who contracts tor such prqects wich a con-
� Vactor(s) license pursuant�to�Me Contractor's License Law). I am awaro that
�, Praot oh their Wo�ker's Compenzation insu�ance shoultl be Provltletl to me.
'❑ I am exempt unticr Section B. & P: C. �or this �eason
Date' Owner '
I hereby certity that I have reatl this appliwtlon antl state lhat the above
information is'correcL I agree to tomply wltb all dty antl county ortlinances
antl state laws relating to bulltling construcNon, antl hereby authorize repre-
sentatives ot this city .to en[¢r 'upon the above-menlionetl property for
�ins0ection purpo50L ,/o '
�Signature � %!i� � Date i�l'S�
Oriverz' License or 55 �^�
� — /s�� �/ I 'I � � , s��.
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER�
DESCRIPTION OF WORK/USE OF BLDG.
TVPE Of PERMIT� GRADING LJ FOUNDATION LJ STRUCTURAL
❑ TENANT ELECTRICAL^ ❑ PLUMBING ❑ MECHANICAL
❑ OTHER .:X � Wt G�LJI i
PROJECT DESCRIPTION Sq. FT. � oCCUaANCv_
- CONSTRUCTIONTYPE VALUATION$
ZONE GRADINGCU.�'D5. ACRFs
3ar Sink
3ackflow Preventer
3atkflow Irrigation
3athtubs
Clarifiers .
�ishwdsher '
Drinking Fountains
Floor Drains •
Floor Sinks
Gas Service Outlets
Intercepmrs ' '
Kitchen Sink - -
Lavatories
P—Trap '
Roof.Dreins
Reinspac[ion Fee . $15
Boiler
Duct-,UnderGround
Duct - Svucmral
Duct-Ventilating � � �
ExhaustSystem ❑ MWtiple❑
Firepl/Fact. BIL ICBO #
Heating System & Ducting
❑ o-i oo,000 aTu � i oo,000 eT
ReinspactionFee �. $15
CMF 0865-46, rev. 10/84 Wnite - Builtling: Canary - Apollcant; Pink - Accounting; Goltlenrotl - Assessor
FEES
ShOW¢fi
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimmin9 Pool w/Spa
Urinal
Water Closet �
Water Heater
Water Service
Auto-Wash �
Laundrv Travs
' laue Fee � $ 3
iANICAL FEE
Hood or Type I ❑ ' �
,Canopy ; Typell �❑
Refrigeration System ,
❑0-100,000 BTU ❑100,000 BTU
System Repair/Alteration �
Fire'Dampers �
Registers �
��
A.P. qW
S� MainBuilding:
E
T F�ont
A Rear
C Right
g Left
Ping.�Ref. #
Planning Notet:
Automatic Washer �
Construction Pole Si
CooKing Unit
Dishwasher
Dryers ❑Gas ❑EI
Fan
F.A.U.
Fixtures ,
Device Boxes
OulIeLS
Switches
Garbage Oisposal
Generator,�0.5 KW
, _
0480 4/0�/85
Accessory Building:
�
Parking Req./Provided
ELECTRICAL .
' � 700�: Tl
Zone '
Z
N
I
' N
G
R
E
Q
M
T
S
Transformer LJ 15-50 KW
� 50+KW
Meter up to 900 amps'
Meter ❑over700amps
Sub Panel
Motors �0.1 HP � 1 h- 8
Inc.Solar �9-15 HP �16-15+
Microwave . .
Pole Light
; Standing Sections
5 KW Trash Compactor
FEES
I Rainspection Fee � �$15 I I luue Pee � ' I $ 3 I
DEVELOPMEN7SERVICESREQUIREMENTS:. � 1
2oning Approved By � Date
Building Approved By Date.�L�
�•__•,__",•__•____�.._ . / � ^_"_ /��ti��C
1
Issue Fee ' $ 3
� SUMMARV OF FEES � � �
BUILDING PERMIT $ SMIP � $
PLAN CHECK $ PEFMIT
PLUMBING $ ' ISSUANCE $
PLAN CHECK 25% $ ENERGY P.C. $
ELECTRICAL $ R� i � � GRADING $
PL4N CHECK 50% $ MICROFILM $ �
MECHANICAL . $ ' TOTAL FEE $ �, n �
PLAN CHECK 25% $ � ' . ' �
/ �
�
CONSTRUCTION ANDPLANNING � POOLa���PA
APPROVALS Permit# Da�e Inspector AppROVALS Permit# Date Inspector
i. Temporary Electrical Service or Pole . 52. Pool & Equipment Location -
.�2: Soil Pipe-Undrgrnd. ' % 53. Steel Reinforcement
' 3. Electrical Conduit Utility-Undrgmd. � 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-Undrgmd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgmd. - � 60. Backwash Lines, P-Trap, � Undrgrnd. �
10. Structural Floor SYstem ' 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection '� 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System - Final
14. Rough Plumbing , 65. Electrical-Final
15: Rough Electrical-Conduit , 66. Solar System-Final
16. Rough Electric Wiring , 67. Fencing & Access Approval
17. Rough Wiring Sign "` � 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling ' 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning'. FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace -' APPROVALS Permit #
21. Ducts, in Struc[ure ' 70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Framing "' 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. floof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical -
27. Frame and Flashing , 76. Dry Standpipe
28. Lathing & Siding r 77. FIXED SYSTEM FINAL
29. Insulation ' 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning � � -
35. Final Gas Pipe-Test .
36. Hood or Canopy .
37. Final Factor,y Fireplace
38. Final Plumbing .
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final � � -
42. Backflow Preventer , _ .
43. Backflow Irrigation � � ' '
44. .Landscape Irrigation System �
45. Sound Attenuation ,
46. Handicap Regulations .
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed ' , , �
49. Electric flelease taEdison . �
50. Gas Release,to Southern California Gas Co '' �
51. CERTIFICATE OF OCCUPANCY � - - ` � �- ,
No. Date ' •