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HomeMy WebLinkAbout1941 CHURCH ST - Building Permits City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY N° 2506 C P. 0. Box 317 Costa Mesa, California The Building located at 1941 Church Street has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group C Occupancy. Use of Building �-0bool _ Legal Description 118.G11-fl8, ass1Q`' (See reverse side for Metes and Bounds) Building Permit No._gl689 01038:.Electrical Permit No. 0�:, Plumbing Permit No. 51199 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments and/or guest rooms ISSUED TO: Building Official ' BBBBRC>� by ,/_lin,. IL& A ,e/ — - ' •m % A Date 3/2 0 /6 sr This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form Bo34—IM—t1-e3.s-s P 27689PAID •, OCT -II-67cnsnQ0 10C" :.;. •, i r,Y ,T COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 9262E For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT 470 610,-..,6 BUILDING For Office Use Only B UILDING ADDRESS RECEIPT No. l4 'COSTA MESA. CALIFORNIA �/� /��'J {/, • RECEIV 0BY ,IT{q1 IIVQD���777 DATE ISS D OWNER - - s /(EGI(.s ''/IY//J6b �7a zanily BUILDING ���� //L � y1 I ��•Y �-e•Cre►v T', 7G'T�I� ADDRESS .Y� TELP.13pR ZONE ./J TYPE /i //�I '7 GROUP CITY E//f4/. •e (.UAn� NO. X141 APPROVED ~ / Q r•1 ARCHITECT 'f j e tiW TEL- BY _/ /'1 T! // h MseRESe 9 7196 .F+( oa'f/4w czar!, ZONE - No.or .� }}II uta or HEW / 7 Cy PLANS �/I BUILDINGji, f,1 CONTRACrOR:YXP/L'TA,C1/' kb S I • r -- ../ �, .P4Y.�<i-iV c=..• y�/`w If`'Ai {U�t`e �DcocivrIO+✓-�+'GO 81 I t0 T/I1 ? ICftgee ADDRESS 'iT vt, . - ( CITY r '-:Tl li I r( ., r: ^, LFGATL'a :. , ..Ai.P.NO.+ Ogg 11:-: / y'T { 9. .:.T' STAT! p TAIL: r• NOTE: NO EAVE OVERHANG SHALL BB LESS THAN' LIC.NO. 2C�-+/,� (] NO• L/$�- - $ f 30•TO SIDE @REAR p.L + ..... .: .EAVES J...'.( rl, ) j r 7 •.)r••r( 1 r., BIZE, ��^^ d (NO.Or BLCGB:,O ALLOWED ` • (U.B.C.REQUIREMENT/ OF LOT el fl1 -Y ' O ? NOW ON LOT%+. I YARDS APPROVED YARDS APPROVED USE DF ' IA" - /,j r'f :LC Id J .):i .. ., N•. MAIN.BUILDING. .1,ACCESSORY BUILDING- EXISTING BLDG. " J, 0 (FROM C/lL'STRB[T 7 SETBACK LINE'roe+ -("1 - FRONT..4s FT, vL. CENTER OF STREET '- '' t REAR YARP• 1."-: ._ -. - I•. . cr_' + ' r r,p;,_".r. • - ' A• . SIDB.YAROII RIGHT__ R' , O ,C;,;, , , •. r. DESCRIPTION OF WORK-, .: ;;,- :- L.molt - .0 FT... _ AR - : 'p + 1,1 Rr.N ALTERATION I• ADDITION _ RE ,,./ DISTANCE' BET.' T BET.[MAIN e '3r. REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. ' ++F O r I +.i r' 1 , VAR:# e T. <:1.('l'X! I.. DAT! , (� r, SUILDING' - -SRO M1 C.U.P 4C -b ) APPROVED. O 2 (O/ SIZE. T ,. nuROOMS. -,STORIl9.• - EXTERIOR WA r-tie-ROOF r r 0_ APPRpYID J 17 y^/ COVERING ♦i,�iC'i I COVERING � - • BY"(.rte •O--r •O'- - DATE !1 (� �^J .-- U BUILDING AND WORK O B!PERFORM '•' I' IG i T.....“-.r._;- . A" /, -2, 1.,, : - y Litt.e-t, - le_ 41--re-02.0 e- �OLDn • c•cI,Y'V -Ff -el w . r, ( , :I I,• L'L crnekrp- e %:: ^'.:Ti T1 ---77 —94—", :. . A_ . " '' S 7 ... ,l` i , F. , , ,. :L, .. r, V •, • '_C�-✓41.�'.SQ.FT, **0 •77-—_ 2 I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS'FOR•THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE 10 COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH AU.'CITY OROl • ARO STATE LAWE.R[OULATINS] ,VALUATION L• Lt.. ..", DI j r.l B UILDING CONSTRUCTION. - - ' ; 7€'� M LSJ7' r l� -;. g.?. 'r,,,,, Q f.;-.7.,PERMIT FEE 6 .; SIGNATURIOr_� I Y"I r�LO J Jf,G iA/i,Jr� �T/Q PERMITTlF' - saJ f - PLAN CHECK S / /'O� w GENT L/ • � AUTHORIZED A $1497 ,. .. TOTAL FEE e3,..r...•<- e•....r.........-I.e./ n(#.'m,.t • JP.wnn°C1. Conditions:- �C. N. - N't: 1. ' The parking lot is to be fully improved with .asphalt pavement\and-striped according to City Standards -subject-to the approval of the Dice'ctor' of Planning. ' 2.- A11 ingress'add egress- t-o`new facilityltobe-approoved -by the-Traffic Engineer.__ - - - — 3. Installation of concrete sidewalks in 5' parkways for 205on Church -,Street arid- I40' on Walnut -Street with-concrete--drive -approach, (s) -by applicant, _at his. expense, under- the direction of the City Engineer, per'specifications of the City of Costa Mesa. - 4; Enlarge, -paaxapagffiaaEiaasxafcxt argi83cxafcx8rskaxhiesaxparking pad- in ' front of existing Building #1 under the direction of the Planning Department. - _ Landscaping and- planters:to be installed under ,the d_irectionof the Director of Planning as indicated on the approved Plot Plan. ' 6. Bumper Guards to be installed in parking lot-on Walnut-Street. - ! 7. That no abandoned -vehicles-be stored on the_ property. 8. That the curb, on the southwest corner', be painted ted for a- .'distance; of 20' from each side 'of'the intersection, subject- to- Traffic -Commis, ion. - • _.-- - 9. Shall provide fire resistive roof as approved. by State--Fire41arshal. 10.- Shall provide an approved -fire alarm 'system:._-_. • 11.. . Shallprovide- fire extinguisher as set forth in Title' 19, State 'Fire Marshal's 'Code for a C Occupancy. T 12. Shall meet-all the requitements of_ Uniform:Fire Cede,:'1961`Edi'tion. __ A complete_set, of_plans_shall_be submitted to the State.Fire Marshal's' office for approval: ' - " - =13. -Tree planting"compatible'with the area..-___.- __ _' - - : . - - - ---- ��� r' • ;� t_- - - • JD v . '.b :?:. • EVl .r 9L'N: • ommsoFmmic., 1941 CHURCH ST uNi: CITY OF COSTA MESA — BUILDING PERMIT ONNER9 NAME IF RtONN: SMITH, PAT PERM NO: B 079256 ADDRESS, 1941 CHURCH ST COSTA MESA, CA 92626 PERMIT NO: B 079256 PLAN CHECK NO: N GOVT: N SUPP: N ARK.MAKING ADDRESS CONSTRUCTION TYPE: PERMIT TYPE: STA PURPOSE: OTH ikCNRECT OR ENDNIEER: UC 140.: JOB DESCRIPTION : T/OFF & REROOF W/BUILT—UP SQ FT: 3, 500 ARCH.OR END:s ADDRESS: MT: CLAIM VALUE: 3, 500 . 00 CALC—VALUE: 3, 500 . 00 GROUP OCC : E-2 / =mamma: WHITNEY ROOFING ( 714 ) 548-0769 CCNTRACTORSMNUNo 790 NEWTON WY COMMENTS : REROOF 2000SF COMMERCIAL BUILDING W/BU ADORES& COSTA MESA CA uO.ND_ 40.022 ********4*****NN ******+E******************* ***** -*************** -K-******sit**x*N- 92627 MY: Z ON ING R EQUIR EMENTS LICENSED CONTRACTORS DECLAMATION:I hereby Arm under penally of perjury that ..•under. • ' • d Chaplet 9 SETBACKS (oommenerg with Section lam)d Division 3 d the Business and Profeaa«ui y .. ..u n hfull • . ., shed. clryuc.NO.-. 28035 yo-Gyss: C 39 uc.NO.: 6�J .1 • : 07/97 MAIN BUILDING ACCESSORY BUILDING 9 Dalt ��j / FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN "'t' Centred= / LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under panty of perjury lbs l - exempt Iron the Condors License Law for the lolfovegreason(Section 7031.5 Unsexes ed Profession Code:My city or coo whin requires a permit to convuct atter,improve, PARKING REQ: PROV: PARCEL : 42626108 ZNE: REF NO: Wndoh,or repo any structure.prior tows issuance.also requires the applicant for such permit to fee a signed statement ernl Che or she PLANNING NOTES> licensed pursuant to the prwieions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Dalian 3 of the Arian and Professions Code]or that he or she is exempt therefrom and the basie for the alleged exemption.My violation of Sects ,> 10,31.5 by any seaboard for a pensubjects the applicant to a civ' d rhe penalty riot more thanhundred damn($5000. ******************************************************************************* ❑ d I,asownrdthepropertyormyempeyeeswithwagesasthe:edecompensaWn,wlldothework,andthesNwwninotitended DEVELOPMENT SERVICES R E Q U I R E M E N"•T S or offered for sale(Sens 7044.Business and Professions Coda:The Contractor'License Law does not apply to an on of progeny �1 who Wt a n,andherselfiin proves thereon who does such work himself or herself or through ph he her own employees.provided that such _ npowmenbvend intended dteredfc sale'R,howenbaling r.the «inpnvemnt ewiwn ehmwbt «ayendmpon,IS ZONING APPROVED BY DATE: . owneriailder will have the burden d proving he or end did not build or improve for the purpose d sale). ❑ I.as owner d the property.am each/fly cnMradng with Emceed c«Wact«s to mrmw the prged(Sects 7044.Business witc 'y Professions Code:The Contractors lractors License Law does notapply to an owner d property who builds or improves thereon and Me BUILDING APPROVED B Y DATE: _ contracts for such projects with a casr'dot(s)licensed pursuant to the Contractors license Law). '2, (r ❑ IemuSection: B.A P.C.,tor this reason: . APPLICATION ISSUED BY: DATE: St/ Dale: °Vi^^ LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware d and understand Me requirements of Caliornia health and Salary Code Sed ss 25505,25533,and g5531,and Nati«app future building occupant win/wM not sal need to comply with said sWeoodee and the ngair'mawh BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING apeniforconmlction or modification from the Ar Quality Management District.Residential constructs appimtss are exempt from these Provision. PERMIT 87 . 25 Dura: Applicant: SHIP/NON—RES PLAN . 74 WORKERS COMPENSATION DECLARATION:I hereby alfinn wrier penalty of perpvy one of the folowing dadaeoaa: ISSUE FEE ❑ Ihave and ml maintain acertificate dconsent toself-insure for workers'compwds a .as provided f« Section BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE cade,f«the p« mr performance dda work f«wt6ch this Permdwinued. TOTALS----> 87 . 99 0 . 00 0 . 00 87 . 99 87 . 99 . 00 ❑ I have and wil maintain workers'compensation mwnence.=required by Section 3700 of the Labor Code.for the . • of work for which this land is issued.My works&mm ion insurance oaths(and poky number en: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 87 . 99 OVER/SHORT : . 00 Cartier. 2H5-9bUN1100326 _ 01 /01 /' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK .re the no001or .., 87 . 25 . 74 certify is I shall CI Ibecco eNwtyn'nadNo the workers'compensaormance al the work tion ttaawshd Ceudorrrtt,ed agree .•' 1 ••n, . •% any to the workers **************N**************************************************************** COM Wy@ice proaa a O eC4kon 3700 d the Labor code.I shall Com .,, .. I IND IVIDUAL F E E B R E AK DOWN V Dale: y� J.,/ ✓ / Applicant: Warning:Faure tosecure woman compensation coverage!.unlawful,and II subject an employee to afnsrwpanmfae and TYPE QTY FDESCRIPTIO N UNIT COST TOTAL COST civil fines tq no ora Mode&thousand doles($104000).In •• to the coat of compaaarlor.dalragws n provided ler In Section3706pygaLaborCoda,hemr. t,andattorney's( -. SFC 3500 REROOF BY VALUE COMMERCIAL NOZONE 1 . 00 3, 500 . 00 1 • CONSTRUCTION LENDING AGENCY:I hereby affirm •• penalty of •-' that there is a mndnaion lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097.Civ ). LENDERS NAME LENDERS ADDRESS: I I catty that I have read this ... . and Slide that the above'•. .s candyisconed.I agree to candy with N city and.. . ... and eerie laws Mcontraction a we ating . .. .' ,coaction d hereby. ..•e representatives of the city to enter upon the above- •.'mored. ... for inspection pur: • ;E'% HIT• Y // G,/,P Wir Dale: w■Jr it. / Ignature of OwwyAgenUAppicanbConbador I (5151.45.WP) WhSe.BWdng&Safely Greer-fie:Canary-Aptnt:Pink-Revenue:Oolderuod-Asweur • C& STR CTION AND PLANNING POOI 'PA APPROVALS Permit# Date Inspector - APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location Z. 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 UF ER Grnd. ' . 57. APPROVAL TO COVER-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test 1 , • 9. Water Pipe-Undrgrnd. 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 8t Vent-Final 13. Roof Drains i,- 64. Plumbing System - Fina) ' 14. Rough Plumbing 65. Electrical-Final ' '7 15. Rough Electrical-Conduit . 66. Solar System-Final / '; • 16. Rough Electric Wiring • 67. Fencing & Access Appr6val 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPASYSTEMS FINAL 19. Rough Heating & Air Conditioning • FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 1'6•` «0 6( - - 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 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 5ervice•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 ei-q-‘u ,(4r 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No - Date MESS: 1941 CHURCH ST UNIT: CITY OF COSTA MESA — SIGN PERMIT PER;: NO; SB . _2L n7 OWNER'S NAME:MARGOLAN FAMILY TRUST #2 ADDRESS: 1922 E. CHAPMAN PERMIT NO; SB 062137 PLAN CHECK NO: 01657-93 S GOVT: N SUPP ; :. ORANGE CA 92667 CONSTRUCTION TYPE; PERMIT TYPE: STR SIG PURPOSE; OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : WALL SIGN SQ FT: ADDRESS: UNIT: CLAIM VALUE: 100 . 00 CALC—VALUE; 100 . 00 GROUP OCC: E-2 / PERMITTEE:MARGOLAN FAMILY TRUST ( 714 ) 997-8640 ADDRESS: 1922 E CHAPMAN AV COMMENTS : TWO WALL SIGNS ORANGE CA 92667 ********4**********x -**r***ar-*-xray******>E***>E*****n4ms*x***Live-****-x***44*m*veli, :' LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section SIGN II N F O R M A T 1 0 N 7000)of Division 3 of the Business and Professions Code.and my license is in full torte and effect. DISTRICT: 3 TYPE• WAIL ILLUMINATION: NON CATEGORY: NEW CITY MC.: STATELIC.: CLASS: DIMENSIONS: 2Ft 06IN X 4FT 00IN AREA: 10. 00SQFT LETTER HT: 10 Date: Si nature: • STREET FRONTAGE 1 : 105 . 00 STREET 1 : CHURCH ST • WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' STREET FRONTAGE 2 • 140 00 STREET 2 : WALNUT ST Compensation Insurance.or a certified copy thereof(Section 3800.Lab.CI. PARCEL : 42626108 ZONE: R2 LOCATION > FRONT: X REAR POLICY NO.: EXP.DATE: BUSINESS NAME: A CHILD ' S PLACE > LEFT: RIGHT: X COMPANY: OTHER TOTALS GROUND SIGN ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. THIS ACTIVITY 20 . 0 0 SOFT OVERALL HEIGHT: OFT O I N THIS SITE 20 . 00SQFT. GROUND CLEARANCE: OFT O.N Date: Applicant: ITEMS OF INFO : 2 PLANTER AREA: 0 .Q0SQFT Irtity EXEMPTION FROM WORKERS'COMPENSATION DECLARATION:hichthis (Thi - need not be completed if ant is for e hundred(5100)or less). ITEMS FOR ACTIVITY: 2 BLDG SET BACK: 40F7 I nifythat inthe performance ofthe work for whichthisper IS issue . hall not emplo rsonina rmanners stobecome COPY VERBIAGE : ACP — A CHILD 'S PLACE LEARNING CENTER — 646-4318 i ubject to kers'C m ensation Laws of California 2 SIGNS TOTAL — 1 TOWARDS EACH STREET FRONT Date: B/ /2- —5 Signature: iLGf6t sL PLANNING NOTES: NOmaking this declaration,you should become subject to the Workers'Compensation provisions of the Labor ************************************************ iff:************iE ****:;*******NOM .II.an Code.you must fonhwith comply with such provisions or this permit shall be deemed revoked. DEVELOPMENT SERVICES R E Q U I R E M — N T S CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the pertormance of the work for I' which this permit is issued(Section 3097.Dv.C). ZONING APPROVED BY . DATE: LENDER: ADDRESS: BUILDING APPROVED BY : DATE: — Z — OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason APPLICATION ISSUED B Y: DATE: 05- 17-93 (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.atter,improve,demolish,or ************:(.>ru{,******Rx<>:**.***verve i!*le Jr t5^*****it*iv**/3-*k ft*****4v**** yr lc x.. ::7e It x re sr it* repair any structure.prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed LEGALIZATION: N F E E S II M M A R Y STRUCTURAL S EGM ENT:Y pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). BLDG PMT PLUMBING EL EC T R_C MECHANIC SIGN SNIP/RES GRADING I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the PERMIT 15 . 00 10. 00 ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law SM IP/NON—RES does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through PLAN 9 . 75 . 50 his or her own employees.provided that such improvements are not intended or offered for sale.II.however the building or ISSUE FEE improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business TOTALS----> 2 5 , 50 0 , 00 9 , 7 5 35 . 25 35 . 25 . 0 0 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of propely who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Slate License Law).I am aware REVENUE DIVISION TOTALS--> COLLECTED; 35, 25 OVER/SHORT : . 00 that proof of their Worker's Compensation insurance should be provided to me. BLDG PMT PLUMBING ELECTRIC LECTRIC MECHANIC SIGN SMIP/TOT GRADING ADING PLAN—CHECK ;A famexemmniTI44 B.SP.C. 15. 00 10 .00 . 50 9 . 7:/ for this reason: DONATION Date: Owner- 1eC�-�� INDIVIDUAL F E E BREAKDOWN I do hereby centyat I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and 25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a TYPE QTY D S C R I P T I O N UNIT COST TOTAL COST permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. NO FEES WERE SELECTED FOR THIS PERMIT Date: Applicant: I hereby certify that I have read this application and state that the above information is correct,I agree to comply ,,h all city and county . ordinances and state laws relating to building construction and h au orf epresentatives of this city to enter uy the above-mentioned pr:.eny for inspection purposes. r` / A.� Date: ,51/_713 Signature: �� 01 00138976-00138979 TOT 35.25 Driver's License or octal Security DATE: 05/12/93 TIME: 09:57 164146 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL PA APPROVALS Permit rr`h- Date Inspector APPROVALS Permit # Date inspector 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 1� 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 Tett 6 Electrical UF ER Grnd. 57. APPROVAL TO COVER-GU'HTE I I 7. Footings 58. Electrical Conduit Undrgr rid. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P.Trsp, ;l Urd•pcu. 10, Structural Floor System 61. APPROVAL TO DECK 11, Property Sewer Line & House Connection 62. Backwash & Receptcr•Final 12, Sewer Cap ' 63. Heater & Vent-Final • 13, Roof Drains 34. P.umbing System • Final 14, Rough Plumbing 65. Electrical-Final 15, Rough Electrical-Conduit 66. Solar System-Find' 16, Rough Electric Wiring I 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. REOUIREMEi'T 20, Rough Factory FIrep'ace APPROVALS P?rmit ry 21, Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping f7 Gas 0 Or 1 23, Gas Pipe-Rough& Test 72. Underground Flus,. (- • - 24, Roof Framing 73. Undergrnd.Storage Tank '.-1 G.; _- Oil 25, Roof Sheathing I 74. Overhead Hydro 26, T-bar Ceiling (Structural, & b;onocoat 75. Cry Chemical 27, Frame and Flashing 76. Dry Standppc ll--- 28, Lathing & Siding 77. FIXED SYSTEM FINAL 29, Insulation I 7E. FIRE PREY. FINAL _1 30, Dr•A':a!l Nad,ng HEALTH DEPT. REOUIRE?.1EwT I 31, Plaster Brown Coat 70. :SINAL INSPECTION 32, Electrical Power Meter.Final 80. "-UOD CERTIFICATE ISSULD 33, Final Electr c Not'::: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • i 36. Hood or Canopy -_ _-- -_ - -- 37- Final Factory Firep'aca - -- I ------ - -- --`- 38. Final Plumbing - - -� -- -----_ -_ -- - _ --39. Water Service-Final 1 40. Gas Service-Final I-- ---- - -- - ---- --- - 41. Solar Domestic-Final 42. Backflow Preventer r i 43. Backf low Irrigation 44. Landscape Irrigation System 45.; Sound Attenuation -46.. Handicap Regulations 47. FINAL STRUCTURE & BUILDING •C///13/,3 0 -i 48. FINAL PLANNING / /` 49. Electric Release to Edison 1 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date